PETITIONER’S STATEMENT
In accordance with the provisions of Section 604 and Section 607 of the Fair Credit Reporting Act, Public Law No. 91- 508, I certify that the information requested below will be used for a “permissible purpose” as defined in the Act, and that the information received will be used for no other purposes.
I am authorized to obtain personal information from motor vehicle records. Information obtained through this report will be used solely in the normal course of business for verifying the accuracy of driving information supplied by the named individual here for the purpose of verifying eligibility to be considered as a commercial motor vehicle driver as defined in Title 49 CFR Parts 382, 383 and 391.

REQUESTED BY:

Green Transfer and Storage Co. Cory Allmaras / Tyler Lawrence 10099 N. Portland Rd. Portland, OR 97203-1359

To

OREGON DMV RECORDS 1905 Lana Avenue NE Salem, OR 97314-2250

DEPT. OF LICENSING Driver Record Section PO Box 9030 Olympia, WA 98507-9030

IDAHO TRANSPORTATION DEPT. Driver Services Section PO Box 34 Boise, ID 837321-0034

DMV&PS Motor Vehicles Records Section 555 Wright Way Carson City, NV 89611-9250

DEPARTMENT OF MOTOR VEHICLES Information Services Branch PO Box 944247, G 199 Sacramento, CA 94244-2470

The following named individual has made application with our company as a driver of a commercial motor vehicle requiring us to obtain and review his/her motor vehicle driving record for the past 3 years, and on an annual basis thereafter, while retained by our company as a driver. CFR Part 391.23