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Safety & Compliance Resources

J. J. Keller protects people and the businesses they run. You can trust our expertise across a wide range of subjects relating to labor, transportation, environmental, and worker safety. Our deep knowledge of federal and state agencies is built on a strong foundation of more than 100 editors and consultants and 70+ years of regulatory compliance experience.

Company & Careers

J. J. Keller protects people and the businesses they run. You can trust our expertise across a wide range of subjects relating to labor, transportation, environmental, and worker safety. Our deep knowledge of federal and state agencies is built on a strong foundation of more than 100 editors and consultants and 70+ years of regulatory compliance experience.

Request For Information From Previous Employer - Snap-Out, 2-Ply, Carbonless, 8-1/2" W x 11" L

Forms are 2-ply, carbonless, 8-1/2" x 11".

Product Code:764
  • Helps you satisfy 49 CFR Section 391.23(d), which requires the prospective employer to obtain driver identification, employment verification, and accident information from a driver/applicant's previous employer(s)
  • Covers the following:
    • Driver/applicant's authorization to release information
    • Employment verification and accident information (including date, location, injuries, fatalities, hazardous material spill details)
  • Snap-out format
  • Twp plies
  • Carbonless
  • Measures 8-1/2" x 11"
  • Made in the USA

Note: This form does not include questions about drug/alcohol testing

View Sample

View a sample Request For Information From Previous Employer.

Carbon Type: Carbonless

Number of Plies: 2

Compliance Topic: Injury & Illness Recordkeeping, Driver Qualification & Hiring

Size: 8.5" x 11"

Format: Snap-out

Need to Purchase a Case?: 2,000 per case

Industry: Transportation, Human Resources

Average Rating: 5.0

BVNumberOfReviews: 1

UNSPSC Number: Examination booklets or forms - 14111533

Advantage Savings: Advantage Savings

Country Of Origin: USA