Fmcsa applicant authorization to release safety permormance history 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by clearly printing your name and Social Security number in the designated fields. Ensure accuracy as this information is crucial for identification.
3. Enter your date of birth, then authorize the release of your safety performance history by signing your name and dating the form.
4. Fill in the details of your previous employer, including their name, address, city, state, zip code, phone number, and fax number.
5. Indicate the position you applied for and provide employment dates with your previous employer. This helps establish your work history relevant to commercial vehicle operation.
6. Complete the safety performance history section by answering whether you drove a commercial motor vehicle and specifying the type if applicable.
7. Document any accidents involving you in the past three years by filling out the required details such as date, location, injuries, fatalities, and hazmat spills.
8. Finally, ensure that all sections are completed accurately before submitting it back to Panhandle Employers Services via fax or email.

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