American Ramp Transit

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Licenses Held State License No Type Expiration Date State License No Type Expiration Date State License No Type Expiration Date

Equipment Experience

Equipment Class (please check)	Equipment Type (Van, Flat, Tank, Reefer)	For how long?	Total miles (approx.)
Tractor and semi-trailer
Tractor w/2 trailers
Straight truck
Other

In what states have you operated in the past 3 years?

Have you ever had your license revoked or suspended? Yes No

If so, when and where?

Why? (please explain)

Have you ever been convicted of a felony? Yes No

If so, when and where?

Why? (please explain)

Have you tested positive for a pre-employment or random Drug or Alcohol test in the past 2 years? Yes No