Independent Contractors Application

Please read the following before going any further. You MUST meet ALL of the following requirements to be considered qualified as a truck driver.

  1. Minimum of 23 years of age.
  2. Minimum of 2 years OTR-18-wheeler experience, within the past 3 years.
  3. No more than 2 moving violations in the past 3 years.
  4. No more than 1 preventable accident in the past 3 years.
  5. No positive drug or alcohol test within the last 10 years.
  6. Felony convictions, within the past 10 years will be subject to review.
  7. Pass a complete D.O.T. physical and NIDA drug screen.
  8. Possess a valid C.D.L.
    • Tank Division requires tank and HAZMAT endorsement. Due to personal Safety concerns, long hair and beards are discouraged in this division.
  9. Must possess a current TWIC card or be able to obtain one. Miller Truck Lines (MTL) will assist in this process.
    • If you CANNOT provide telephone numbers from past employers, your application will NOT be processed.
    • ALL blanks must be completed. Be accurate and truthful. MTL will contact your past employers BEFORE considering you for employment.
    • You MUST have a telephone.

I authorize you to make such investigations and inquiries of my personal employment, financial or medical history and other related matters, as may be necessary in arriving at an employment decision. I hereby release employers, schools, health care providers and other persons from all liability in responding to inquiries and releasing information in connection with my application. In the event of employment, I understand that false or misleading information given on my application or interview may result in discharge. I understand, also, that I am required to abide by all rules and regulations of Miller Truck Lines, LLC, Federal State, and Local laws.

Applicant Information

Tickets
Accidents
Felonies
DUI/DWI
Misdemeanors
Owner-Operator
3rd Party
Van/Reefer
Flatbed
Tanker

Employment History

Employer 1

Employer 2

Employer 3

Employer 4

Employer 5

Employer 6

Employer 7

Employer 8

Employer 9

Employer 10

Employer 11

Employer 12

Employer 13

Employer 14

Employer 15

Employer 16

Employer 17

Employer 18

Employer 19

Employer 20


Pre-Contract Questionnaire

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No

Have you ever...

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How many...

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Can you...

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N/A
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No


DISCLOSURE AND AUTHORIZATION REGARDING PROCUREMENT OF BACKGROUND REPORTS

It is recognized and understood that the Fair Credit Reporting Act provides that anyone "who knowingly and willfully obtains information on a consumer from a consumer reporting agency under false pretenses" shall be fined not more than $2,500 or imprisoned not more than a year, or both.

National Background Reporting

In connection with my application for employment (including contract for services or volunteers), I understand that investigative background inquiries are to be made on me, which may include consumer credit, criminal, civil litigation, motor vehicle, workers compensation, and other reports. These reports may include information as to my character, work habits, performance, education and experience along with reasons for termination of employment from previous employers. Further, I understand that you will be requesting information from various Federal, State, and other agencies which maintain records concerning my past activities relating to my driving, credit, criminal, civil and other experiences.

I authorize, without reservation, any party or agency contacted to furnish the above mentioned information and release all parties involved from any liability and responsibility for doing so. I hereby consent to obtaining the above information from the company above and/or any of their licensed agents. This authorization and consent shall be valid in original, fax or copy form. I further authorize ongoing procurement of the reports mentioned above at any time during my employment, (contract or volunteering) and have received a copy of the Consumer Reports Notification, regarding pulling of such consumer reports. In the event information from your report is used in whole or in part in making an adverse decision in regards to your employment, before making an adverse decision, you will be provided with a copy of the consumer report along with a copy of your rights under the FCRA.

M
F

Previous Address

Motor Vehicle Report

*Responses to these are completely voluntary. You need not respond to have your application considered. However, without this information, we may be unable to distinguish you from another in the event we discover adverse information during our background investigation.

Pre-hire Check List

Before Miller Truck Lines, LLC can prepare a lease agreement; we MUST have the following paperwork:

  • Certificate of Title
  • Title Receipt
  • Bill of Sale
  • Current Registration
  • Cab Card (current)
  • Form 2290 Receipt (paid - schedule of Heavy Highway Use)
  • Truck Inspection (recent - truck will also have to be inspected and approved through the Miller Truck Lines shop)
  • If you have your own trailer, we'll need your title and registration

Notes:

  1. Insurance, if you carry your own - you must have bobtail insurance (you must carry physical damage, if you have a lien on your truck or if you are a lease purchase independent contractor).
  2. Workman's Compensation – you must provide proof or you can purchase Occupational Accident ($150.60/month)

Annual inspections must be performed in our maintence shops.

Processing Fees Notes

Effective January 1, 2006 the following processing fees have been established for Owner Operators and/or their drivers:

  1. $150.00 fee will be assessed if the owner operator’s and/or third party driver completes Miller Truck Lines orientation process and does not exhaust a minimum of 90 days of contract.
  2. $75.00 fee will be assessed if Miller Truck Lines Recruiting Department completes the application process and owner operator and/or third party driver does not qualify for contract.

Lease Contractor Information

Combined with what you have learned from us over the phone and the above information, if you would like to pursue becoming a lease contractor with MTL, we ask that you complete the information listed below. All this material will help us in considering your qualifications.

I authorize you to make any such investigations and inquiries regarding the information supplied on this form as deemed necessary in arriving at consideration of my lease application. I hereby release employers, schools, financial institutions, credit reporting services, and any and all entities associated with the information associated with my person and/ or business as requested by MTL in making their determination. I understand that providing false or misleading information may result in the denial of my lease application. In addition, should my lease be approved, I understand that I am required to abide by all the rules and regulations of MTL, Federal, State, and Local Laws. Also, I understand and agree that I am seeking a position as an independent contractor, and not an employee or agent of Miller Truck Lines, LLC.

Van/Reefer
Flatbed
Tanker
Mileage Lease Plan
Percentage Lease Plan
I have HAZMAT endorsement.
I have a tank endorsement.
I have a TWIC Card
I am qualified and can cross the Canadian Border.

Tractor/Trailer Owner Information

Questionnaire

Thank you for answering the following questions. These will be of assistance in understanding your expectations.

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No
Yes
No
Yes
No

Truck Information

Yes
No
Yes
No

Trailer Information (if applicable)

Yes
No
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No
Base Plate
Physical Ins.
Bob Tail Ins.
Pre-Pass
Occupational Ins.

When you come to orientation, you will need to bring the following with you:

  • Original Title & Current Registration
  • Copy of the Title Receipt
  • Copy of the paid receipt for your current year 2290
  • Copy of the Bill of Sale for your truck

Your truck will have to pass inspection in the MTL Maintenance Shop


Authorization & Other Release Information

Important Notice Regarding Background Reports From the PSP Online Service

In connection with your application for employment with Miller Truck Lines, L.L.C. (MTL) (“Prospective Employer”), it may obtain one or more reports regarding your credit, driving, and/or criminal background history from a consumer reporting agency and/or other sources. If the Prospective Employer uses any information it obtains from a background report in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer will provide you with a copy of the report upon which its decision was based and a written summary of your rights under the Fair Credit Reporting Act before taking any final adverse action. If any final adverse action is taken against you based upon a background report, the Prospective Employer will notify you that the action has been taken and that the background report was the reason for the action. The Prospective Employer cannot obtain background reports from consumer reporting agencies or other sources regarding you unless you consent in writing. If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below:

I authorize MTL ("Prospective Employer") to contact any organization or individual that I have listed on my employment application or resume or mentioned in job interviews and obtain from them any relevant information about my job qualifications, including my experience, skills, and abilities. I understand that I am consenting to the release of safety performance information including crash data from the previous five (5) years and inspection history from the previous three (3) years, as well as any reference-related information about the held or known by my former employers, supervisors, and co-workers. In addition, I consent to the release of any information about my education, experience, abilities, or work-related characteristics or traits held or known by other organizations or individuals, including schools and educational institutions, professional or business associates, and friends and acquaintances that Prospective Employer might contact in the course of conducting a reference check or background investigation of my suitability for employment.

I understand and acknowledge that this release of information can involve my qualifications, performance, credentials, or other characteristics or factors affecting my suitability for employment with Prospective Employer. Specifically, I am authorizing the release of any information about my performance, experience, capability, attitude, specific events, or other work-related characteristics that currently are in the possession of the requested organizations or their managers or representatives.

In exchange for Prospective Employer’s consideration of my employment application, I agree not to file or pursue any complaints, claims, or legal actions of any kind against any organization or individual that provides work-related information about me to Prospective Employer or its agents in accordance with the terms and intent of this release. I also agree not to file or pursue any complaints, claims, or legal actions against Prospective Employer or any of its employees, representatives, or agents, arising out of their efforts to obtain work-related information about me.

I have read the above Notice Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this consent form, Prospective Employer and/or any entity it retains to obtain such background reports may obtain reports of my credit, driving, and/or criminal background history in addition to information regarding my background, reference, education, specific events, and past employment.

I hereby authorize Prospective Employer and its employees, agents, and affiliates to obtain the information authorized above.

I hereby authorize release of information from my Department of Transportation regulated drug and alcohol testing records by my previous employer, listed in Section 1-B, to the employer listed in Section 1-A. This release is in accordance with DOT Regulation 49 CFR Part 40, Section 40.25. I understand that information to the released in Section II-A by previous employer, is limited to the following DOT-regulated testing items:

  1. Alcohol test with a result of 0.04 or higher;
  2. Verified positive drug tests;
  3. Refusals to be tested;
  4. Other violations of DOT agency drug and alcohol testing regulations;
  5. Information obtained from previous employers of a drug and alcohol rule violation;
  6. Documentation, if any, of completion of the return-to-duty process following a rule violation.

MANDATORY USE FOR ALL ACCOUNT HOLDERS
Important Notice Regarding Background Reports From the PSP Online Service
In connection with your application for employment with Miller Truck Lines, LLC (“Prospective Employer”), Prospective Employer, its employees, agents or contractors may obtain one or more reports regarding your driving, and safety inspection history from the Federal Motor Carrier Safety Administration (FMCSA).

When the application for employment is submitted in person, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer will provide you with a copy of the report upon which its decision was based and a written summary of your rights under the Fair Credit Reporting Act before taking any final adverse action. If any final adverse action is taken against you based upon your driving history or safety report, the Prospective Employer will notify you that the action has been taken and that the action was based in part or in whole on this report.

When the application for employment is submitted by mail, telephone, computer, or other similar means, if the Prospective Employer uses any information it obtains from FMCSA in a decision to not hire you or to make any other adverse employment decision regarding you, the Prospective Employer must provide you within three business days of taking adverse action oral, written or electronic notification: that adverse action has been taken based in whole or in part on information obtained from FMCSA; the name, address, and the toll free telephone number of FMCSA; that the FMCSA did not make the decision to take the adverse action and is unable to provide you the specific reasons why the adverse action was taken; and that you may, upon providing proper identification, request a free copy of the report and may dispute with the FMCSA the accuracy or completeness of any information or report. If you request a copy of a driver record from the Prospective Employer who procured the report, then, within 3 business days of receiving your request, together with proper identification, the Prospective Employer must send or provide to you a copy of your report and a summary of your rights under the Fair Credit Reporting Act.

The Prospective Employer cannot obtain background reports from FMCSA unless you consent in writing.

If you agree that the Prospective Employer may obtain such background reports, please read the following and sign below:

I authorize Miller Truck Lines, LLC (“Prospective Employer”) to access the FMCSA Pre-Employment Screening Program (PSP) system to seek information regarding my commercial driving safety record and information regarding my safety inspection history. I understand that I am consenting to the release of safety performance information including crash data from the previous five (5) years and inspection history from the previous three (3) years. I understand and acknowledge that this release of information may assist the Prospective Employer to make a determination regarding my suitability as an employee.

I further understand that neither the Prospective Employer nor the FMCSA contractor supplying the crash and safety information has the capability to correct any safety data that appears to be incorrect. I understand I may challenge the accuracy of the data by submitting a request to https://dataqs.fmcsa.dot.gov. If I am challenging crash or inspection information reported by a State, FMCSA cannot change or correct this data. I understand my request will be forwarded by the DataQs system to the appropriate State for adjudication.

Please note: Any crash or inspection in which you were involved will display on your PSP report. Since the PSP report does not report, or assign, or imply fault, it will include all Commercial Motor Vehicle (CMV) crashes where you were a driver or co-driver and where those crashes were reported to FMCSA, regardless of fault. Similarly, all inspections, with or without violations, appear on the PSP report. State citations associated with FMCSR violations that have been adjudicated by a court of law will also appear, and remain, on a PSP report.

I have read the above Notice Regarding Background Reports provided to me by Prospective Employer and I understand that if I sign this consent form, Prospective Employer may obtain a report of my crash and inspection history. I hereby authorize Prospective Employer and its employees, authorized agents, and/or affiliates to obtain the information authorized above.

NOTICE: This form is made available to monthly account holders by NICT on behalf of the U.S. Department of Transportation, Federal Motor Carrier Safety Administration (FMCSA). Account holders are required by federal law to obtain an Applicant’s written or electronic consent prior to accessing the Applicant’s PSP report. Further, account holders are required by FMCSA to use the language provided in paragraphs 1-4 of this document to obtain a prospective Applicant’s consent. The language must be used in whole, exactly as provided. The language may be included with other consent forms or language at the discretion of the account holder, provided the four paragraphs remain intact and the language is unchanged.


About Miller Truck Lines

Miller Truck Lines is family owned and operated by James and Bonnie Miller, along with their sons. Miller Truck Lines was incorporated in April of 1983 and have gained respect and loyalty throughout the industry. The MTL management team has assembled a staff of dedicated transportation specialists that understand supply chain logistics, just-in-time (JIT) and truckload dedicated freight. Miller Truck Lines transportation services include refrigerated, dry van, tanker, flatbed, and a regional wrecker service.

Miller Truck Lines, LLC

CORPORATE OFFICES
105 North 8th Avenue
P.O. Box 665
Stroud, Oklahoma 74079


TULSA OFFICE
4231 South Elwood
Tulsa, Oklahoma 74107


CUSTOMER SERVICE
(918) 447-2100


DRIVERS RECRUITING
(918) 447-2103

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