Non- Driver Application

I have read and understood the pre-employment policies of Santa Fe Tow service.

I certify that this application was completed by me and that all entries on it and information in it are true and complete to the best of my knowledge.

I authorize Santa Fe Tow Service to make such investigations and inquiries of my personal, employment, financial, or medical history, and other related matters as may be necessary for arriving at an employment decision. (Generally, inquiries regarding medical history will be made only if and after a conditional offer of employment has been extended.) I hereby release employer, school, health care providers, and other persons from all liability in responding to inquiries and releasing information in connection with my application.

In the event of employment, I understand that false or misleading information given in my application or interviews may result in discharge. I understand, also, that I am required to abide by all the rules and regulations of Santa Fe Tow Service.

I understand that information I provide regarding current and/or previous employers may be used, and those employers will be contacted, for the purpose of investigating my safety performance history as required by 49 CFR 391.23(b) and (e). I understand that I have the right to:

• Review information provided by current/previous employers;
• Have errors in the information corrected by previous employers and for those previous employers to re-send the corrected information to Santa Fe Tow service; and
• Have a rebuttal statement attached to the alleged erroneous information if the previous employer and I cannot agree n the accuracy of the information.