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I hereby authorize MTED Transportation to request my driving and background records for reasons of screening as required by Section 391.23 of the FMCSR. You, the applicant are released and not held accountable from any and all liability which may result from obtaining such information.
As stated in the provisions of Section 604 and 607 of the Fair Credit Reporting Act, Public Law 91‐ 508, amended by the Consumer Credit Reporting Act of 1996 (Title II, Subtitle D, Chapter1, of Public Law 104‐208), I, the applicant hereby certify the following:
I, the applicant have authorized in writing the attainment of this report.
I, the applicant have been informed in a separately written disclosure that a consumer report may be obtained for driver qualification purposes.
Following requested information will be used for a “lawful purpose” (i.e., information for qualification purposes of a CMV driver) and information will not be used for any other purpose.
The information obtained will not be used in violation of any federal or state equal opportunity law or regulation;
Before making an unfavorable decision based in whole or in part on the report, the applicant will receive a copy of the requested report and the summary of consumer rights as provided with the report by the consumer‐reporting agency.
I also hereby certify that this report request and the above applicant’s release notice meet the definition of “permissible uses” of state motor vehicle records under the provision of the Driver’s Privacy Protection Act of 1994 (Public Law 103‐322, Title XXX, Section 300002(a)).
