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  • Cincinnati, OH
  • (513) 771 1850
  • info@taylordist.com
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  • About Taylor
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    • Our Values
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    • Our History
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  • Distributing Services
    • Services Overview
    • Drayage – Port Services
    • Dedicated – Contract Fleet
    • Transloading
    • Warehousing – Cincinnati
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  • Warehouse
  • Truck Driving Jobs
    • Driver Verification
    • Company Drivers
    • Owner Operators
    • Why Drive for Taylor
  • Load Match
  • Contact
  • Get a Rate
cropped-cropped-Taylor-Distributing-Logo-1.png TDC Icon
  • About Taylor
    • Contact Us
    • Our Values
    • Our Culture
    • Our History
    • Blog
  • Distributing Services
    • Services Overview
    • Drayage – Port Services
    • Dedicated – Contract Fleet
    • Transloading
    • Warehousing – Cincinnati
    • Get a Quote
  • Warehouse
  • Truck Driving Jobs
    • Driver Verification
    • Company Drivers
    • Owner Operators
    • Why Drive for Taylor
  • Load Match
  • Contact
  • Get a Rate

© 2019

Step 1 of 6

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  • StreetCityState & ZipHow Long? 
  • (Answer only if a job requirement)
  • EMPLOYMENT HISTORY

    All driver applicants to drive in interstate commerce must provide the following information on all employers during the preceding 3 years. List complete mailing address, street number, city, state, and zip code.

    Applicants to drive a commercial motor vehicle in intrastate or interstate commerce shall also provide an additional 7 years' information on those employers for whom the applicant operated such vehicle.
    (NOTE: List employers in reverse order starting with the most recent. Attach another sheet at the bottom of this page as necessary.)
  • Employer

  • Employer

  • Employer

  • If you require space for more employers, please Click Here to download an extra sheet to fill out, then upload it using the button below.
  • Max. file size: 8 MB.
  • DateNature of AccidentFatalitiesInjuriesHazardous Material Spill 
    Click the plus (+) sign to add another accident
  • LocationDateChargePenalty 
    Click the plus (+) sign to add another violation
  • StateLicense No.ClassEndorsement(s)Expiration Date 
    Click the plus (+) sign to add another violation
  • Driving Experience

  • Type (Van, Tank, Flat, Dump, Refer)From (Date)To (Date)Approx. No. of Miles (Total)
  • Type (Van, Tank, Flat, Dump, Refer)From (Date)To (Date)Approx. No. of Miles (Total)
  • Type (Van, Tank, Flat, Dump, Refer)From (Date)To (Date)Approx. No. of Miles (Total)
  • Type (Van, Tank, Flat, Dump, Refer)From (Date)To (Date)Approx. No. of Miles (Total)
  • From (Date)To (Date)Approx. No. of Miles (Total)
  • From (Date)To (Date)Approx. No. of Miles (Total)
  • Type (Van, Tank, Flat, Dump, Refer)From (Date)To (Date)Approx. No. of Miles (Total)
  • Click the plus (+) sign to add another
  • Click the plus (+) sign to add another
  • Click the plus (+) sign to add another
  • Experience and Qualifications - Other

  • Education

  • Select highest grade completed.
  • Select highest grade completed.
  • Select highest grade completed.
  • To Be Read And Signed By Applicant

  • This certifies 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.

  • Type name to sign
  • MM slash DD slash YYYY
  • Fair Credit Reporting Act Disclosure Statement

  • In accordance with the provisions of Section 604(b)(2)(A) of the Fair Credit Reporting Act, Public Law 91-508, as amended by the Consumer Credit Reporting Act of 1996 (Title II, Subtitle D, Chapter I, of Public Law 104-208), you are being informed that reports verifying your previous employment, previous drug and alcohol test results, and your driving record may be obtained on you for employment purposes. These reports are required by Sections 382.413, 391.23, and 391.25 of the Federal Motor Carrier Safety Regulations.

  • Type name to sign
  • MM slash DD slash YYYY
  • Important Notice Regarding Background Reports From The PSP Online Service

  • In connection with your application for employment with Taylor Distributing ("Prospective Employer"), it may obtain one or more reports regarding your driving, and safety inspection history from the Federal Motor Carrier Safety Administration (FMCSA). If the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer will provide you with a copy of the report upon which its decision was based and a written summary of your rights under the Fair Credit Reporting Act before taking any final adverse action. If any final adverse action is taken against you based upon your driving history or safety report, the Prospective Employer will notify you that the action has been taken and that the action was based in part or in whole on this report. The Prospective Employer cannot obtain background reports from FMCSA unless you consent in writing. If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below:

    I authorize Taylor Distributing ("Prospective Employer") to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information regarding my safety inspection history. I understand that I am consenting to the release of safety performance information including crash data from the previous five (5) years and inspection history from the previous three (3) years. I understand and acknowledge that this release of information may assist the Prospective Employer to make a determination regarding my suitability as an employee.

    I further understand that neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. I understand I may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If I am challenging crash or inspection information reported by a State, FMCSA cannot change or correct this data. I understand my request will be forwarded by the DataQs system to the appropriate State for adjudication.


    I have read the above Notice Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this consent form, Prospective Employer may obtain a report of my crash and inspection history. I hereby authorize Prospective Employer and its employees, authorized agents, and/or affiliates to obtain the information authorized above.

  • MM slash DD slash YYYY
  • Type name to sign
  • This field is for validation purposes and should be left unchanged.
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9287 Meridian Way

West Chester, OH 45069

Phone: 513-771-1850
E-mail: info@tayloridst.com rates@taylordist.com
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