Driver/Employee List

Company Name

Please choose an option(Required)

DOT Regulated

NON-DOT Testing

Please select your regulating agency(Required)

FMCSA

PHMSA

FTA

NONE

Phone

Fax

Date

Email to receive copy of your deletions and additions for your DOT or company records

Company representative completing form

Delete these Drivers/Employees

Please list employees to be deleted alphabetically

Name (Last, First)

Date of Birth

CDL State

CDL Number

Add these Drivers/Employees

Please list employees to be added alphabetically

Name (Last, First)

Date of Birth

CDL State

CDL Number

Comments

This field is for validation purposes and should be left unchanged.