Driver Application for Employment

BackOfficeFleet — Driver Qualification File
DQF-APP-001
Required per 49 CFR §391.21 — Must be completed and signed by applicant prior to driving assignment
1 Motor Carrier Information §391.21(b)(1)
Company Name
BackOfficeFleet, LLC
Company Address
4200 Euclid Ave, Suite 300, Cleveland, OH 44103
USDOT Number
3847291
MC Number
MC-1284560
2 Applicant Information §391.21(b)(2)
Last Name
Carter
First Name
John
Middle Name
Thomas
Date of Birth
01/08/1971
Social Security Number
XXX-XX-4218
Phone Number
206-667-3424
Email Address
jcarter@yahoo.com
Application Date
07/15/2025
Current Address
1240 W 6th St, Cleveland, OH 44113

Driver Photo
DRV-001 driver photo
Driver photo verified
Headshot on file from Delta Advanced Trucking driver records.

Position Applied For
Position
OTR Driver
Type
Full-Time
Date Available
08/01/2025
3 Residence History — Previous 3 Years §391.21(b)(3)
Address City, State, ZIP From To
1240 W 6th St Cleveland, OH 44113 03/2021 Present
875 Madison Ave, Apt 4B Lakewood, OH 44107 06/2018 02/2021
4 License Information §391.21(b)(5)
Issuing State License Number Class Endorsements Restrictions Expiration
Ohio OH1668243 Class A T, N None 08/22/2027
5 Driving Experience §391.21(b)(6)
Tractor-Semitrailer 12 yrs
Straight Truck 4 yrs
Tanker 6 yrs
Doubles / Triples 2 yrs
Flatbed 5 yrs
Reefer 8 yrs
Total Miles Driven (Approximate)
~1,200,000 miles
6 Accident Record — Previous 3 Years §391.21(b)(7)
Date Nature of Accident Location Fatalities Injuries
No reportable accidents in the preceding 3-year period.
7 Traffic Violations & Forfeitures — Previous 3 Years §391.21(b)(8)
Date Violation Location / State Vehicle Operated Disposition
03/12/2023 Speeding — 10 mph over posted limit I-77, Cuyahoga Co., OH Tractor-Semitrailer Paid / Closed
8 License Denial, Revocation, or Suspension §391.21(b)(9)
I certify that no license, permit, or privilege to operate a motor vehicle has ever been denied, revoked, or suspended.
I have had a license, permit, or privilege denied, revoked, or suspended. Details are provided below:
Details (if applicable)
N/A
9 Employment History — Previous 10 Years §391.21(b)(10)
Employer Name
Great Lakes Transport, Inc.
Employer Address
8100 Brookpark Rd, Cleveland, OH 44129
Phone
216-459-7200
Position Held
OTR Driver
From
04/2019
To
07/2025
Reason for Leaving
Seeking better home time
Subject to FMCSRs?
Yes
Subject to DOT Drug/Alcohol Testing? (49 CFR Part 40)
Yes
May We Contact?
Yes
Employer Name
Midwest Freight Solutions, LLC
Employer Address
2750 W 130th St, Parma, OH 44130
Phone
440-886-3300
Position Held
Regional Driver
From
11/2015
To
03/2019
Reason for Leaving
Company downsized regional division
Subject to FMCSRs?
Yes
Subject to DOT Drug/Alcohol Testing? (49 CFR Part 40)
Yes
May We Contact?
Yes
Employer Name
Erie Shore Carriers
Employer Address
1600 E 55th St, Cleveland, OH 44103
Phone
216-391-4400
Position Held
Local / P&D Driver
From
06/2010
To
10/2015
Reason for Leaving
Promoted to OTR opportunity
Subject to FMCSRs?
Yes
Subject to DOT Drug/Alcohol Testing? (49 CFR Part 40)
Yes
May We Contact?
Yes
10 Education Industry Standard
School / Institution Location Years Attended Graduated? Degree / Certificate
Lincoln-West High School Cleveland, OH 1985 – 1989 Yes High School Diploma
Ohio CDL Training Academy Parma, OH 2010 Yes CDL Class A Certificate
11 DOT Drug & Alcohol Testing History §391.21(b)(10) / 49 CFR Part 40
Have you ever tested positive or refused a DOT pre-employment, random, post-accident, reasonable suspicion, return-to-duty, or follow-up drug or alcohol test with any previous employer? No
I authorize BackOfficeFleet, LLC to obtain my drug and alcohol testing records from my previous DOT-regulated employers listed in Section 9, in compliance with 49 CFR §40.25.
12 Safety Performance History — Records Release Authorization §391.23(d) / §391.53
13 Fair Credit Reporting Act Disclosure & Consent FCRA / Industry Standard
I acknowledge receipt of the FCRA disclosure above and authorize BackOfficeFleet, LLC to obtain consumer reports and/or investigative consumer reports for employment purposes.
I authorize a pre-employment background check including criminal history records and MVR from all states in which I hold or have held a license.
14 Applicant Certification & Signature §391.21(b)(11)
Applicant Certification
I certify that the information provided in this application is true and complete to the best of my knowledge. I understand that any falsification, misrepresentation, or omission of information on this application or any other required document may result in denial of employment or, if already employed, immediate termination. I authorize BackOfficeFleet, LLC to verify all information provided and to contact all previous employers, references, and educational institutions listed herein. I understand that this application is not a contract of employment and that, if hired, my employment is at-will and may be terminated by either party at any time, with or without cause.
John T. Carter
Applicant Signature
07/15/2025
Date

For Carrier Use Only
Reviewed By
S. Holmes — Fleet Compliance
Review Date
07/16/2025
Assigned Driver ID
DRV-001
Application Status
APPROVED