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Click ‘Get Form’ to open the pdf 643 fs c2 3686 print form in our editor.
Begin by entering your personal information in the 'COMPLETED BY DRIVER' section. Fill in your name, social security number, home terminal (city and state), driver's license number, date of employment, and expiration date.
In the violations section, list any traffic violations you have been convicted of or for which you have forfeited bond during the past 12 months. If there are none, check the box indicating 'None.'
Sign and date the certification at the bottom of the driver section to confirm that all information is accurate.
The motor carrier will then review your driving record. They will complete their section by checking whether you meet minimum safe driving requirements and signing off on it.

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