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Mechanic Application

TDF Enterprises, LLC

Employment Application

Position Applying for: Mechanic

Personal Information

First Name:

Middle Name:

Last Name:

Street Address:

City, State, Zip Code:

Phone Number:

E-mail address:

Social Security Number

Date of Birth

Are you a US Citizen or do you have a qualifying legal status for employment in the US?

Have you been convicted of, or pleaded no-contest to, a felony within the last 10 years? (NOTE: Felony convictions are not an automatic disqualifier for employment)

If yes, please describe the nature of the crime(s), when and where convicted, and the disposition/final settlement of the case:

Have you ever applied to / worked for TDF Enterprises before?

If yes, please explain (include dates):

Do you have any friends or relatives, working for TDF Enterprises?

If yes, state name & relationship:

License Information

State:

License Number:

CDL Class:

Passenger Endorsement:

Air Brake Endorsement (No restriction):

Have you had a CDL for at least 1 year:

Have you ever been denied a license, permit, or privilege to operate a motor vehicle?

Has any license, permit, or privilege ever been suspended or revoked?

If you answered YES to either of the 2 above questions, please provide detail:

Please describe your driving experience (type of vehicle and number of years and approximate mileage:

Please provide information about any accidents going back 5 years, regardless of at-fault or in a personal/commercial vehicle. Provide dates and any details including fatalities and injuries:

Please provide information about any traffic violations and license revocations going back 5 years. You may omit parking violations. Provide dates, type of violation, date, and any penalty assigned:

Experience

Please describe your relevant experience:

Experience

International/Navistar T444e engines

International/Navistar DT466 engines

International/Navistar MaxxForce engines

Air brake systems

Employment History - Please go back 10 years.

Are you currently employed?

For each employer going back 10 years, please provide:
- Name of Employer
- Phone Number
- Email address (if applicable)
- Business Type
- Complete Address
- Dates of Employment

References

Please provide 3 (non-family member) professional references. For each, please provide:
- First & Last Name
- Phone number
- Email address
- Complete Address

Emergency Contacts

Contact:

Relationship:

Phone number(s):

Certification

I certify that the information contained in this application is true and complete.

I understand that false information may be grounds for not hiring me or for immediate termination of employment if I am hired.

I also acknowledge that my hiring is subject to insurance underwriting and if the Employer is unable to insure me for reasonable costs then I may not be hired or if already hired my employment may be terminated.

I authorize the verification of any and all information listed above, including previous employer driving, drug, and alcohol checks.

I acknowledge I have the following rights:

(i) The right to review information provided by previous employers;
(ii) The right to have errors in the information corrected by the previous employer and for that previous employer to re-send the corrected information to the prospective employer
(iii) The right to have a rebuttal statement attached to the alleged erroneous information, if the previous employer and the driver cannot agree on the accuracy of the information.

I authorize TDF Enterprises LLC and its agents to pull my Motor Vehicle Record (MVR), USDOT Pre-Employment Screening, and/or other similar reports.

Documents

Please upload a photo of the front of your drivers license:

DL-Front

Please upload a photo of the back of your drivers license:

Back of drivers license

Please upload a photo of either your social security card or passport ID page:

Social Security Card or Passport

Please upload a photo of your medical certificate:

Medical Certificate

Leave this empty:

Your legal name

Your email address

Please Confirm full name and signature.

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Timestamp

Audit

October 29, 2021 3:06 pm CDT

Mechanic Application Uploaded by TDF Enterprises, LLC - [email protected] IP 108.160.230.66