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Owner Operator Application Form All Fields Required
*****Disclaimer*****
Upon completion of this form, Florida Rock & Tank Lines, Inc. will contact you, and if qualified, your MVR and DAC will be pulled and examined. By submitting this form, you agree to these conditions and grant permission to Florida Rock & Tank Lines, Inc. to review driving, employement and safety records or information.
Contact Info
Name(first, last)
Social Security #
Birth Date (mm/dd/yy)
Current Age
Address
City
County
State
Zip
Phone Number   Please include area-code.
Contact Email  
Qualifications
Driver's License # and State   
Expiration Date (xx/xx/xx)
Endorsement
Other CDL's Previously Held (license # and state)   
Expiration Date
1. Do you have two years of verifiable tractor-trailer experience or one year tractor-trailer experience and a certificate from a truck driving school?
2. Have you had a DWI, DUI, or reckless driving conviction within the past 10 years?
3. Has your current license or any license ever been suspended or revoked?
4. How many moving violations (everything but parking tickets) have you had in the past 3 years?
5. How many accidents (whether your fault or not) have you been involved in in the past 3 years?
6. How many employers have you had in the past 3 years?
7. Are you presently employed?
8. Have you ever been convicted
of a felony?
9. Have you ever tested positive
on a drug test OR tested more than
.02 BAC in an alcohol test?
Please List Previous Employers w/ Phone numbers and Dates of Employment
Most Recent Employer
2nd Most Recent Employer
3rd Most Recent Employer
   
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