Trans Power Corporation of Mississippi

Declaration of Unemployment, Self Employed, or Non-Verifiable Time Periods

 Under the Federal Motor Carrier Safety Regulations (Section 391. - 391.23) requires us to verify the employment background of all prospective driver applicants for the preceding (3) three years.

This form is designed to assist with the period(s) in question of self-employed, non-employed & or non-verifiable time-periods where the previous employer is no longer in business & /or cannot be reached by any means.

Include a copy of the following documents if possible: W-2, 1099, Business License, Statements, Check Stubs, letters signed from individuals that are aware of this as stated.

The following gap(s) listed are per your application history.

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I confirm the following:
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I confirm the following: