Drive CheckPERMISSION TO CHECK DRIVING RECORD
The position that you are applying for requires extensive driving and/or the possession of a
commercial driver's license. We will be verifying your driving record and the type of license(s)
that you currently hold with the Department of Motor vehicles. We will do this at no cost to you.
This form must be completed and returned with your application.
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I understand that by signing this form I am giving Pierce County permission to obtain a copy of my driving record which will indicate the type of license(s) that I currently hold and any past or pending driving violations.
Date: _________________________ Signature: __________________________________
Full Name: ____________________________________________________________________
(Please print) First Middle Last
Driver's License Number: _________________________________________________________
_______________________ _________________________
Issuing State Date of Birth
Type: Regular___________ Commercial____________
For Commercial Driver's Licenses, please indicate which class of license it is and the various endorsements you already have:
Class__________________ ____ Combination Vehicles
____ General Knowledge ____ Hazardous Materials
____ Passenger Transport ____ Tankers
____ Air Brakes ____ Doubles/Triples
Note: If you would like more information on how to obtain a copy of your driving record, you should contact: Wisconsin Department of Transportation
Driver Record Files
P.O. Box 7918
Madison, WI 53707-7918
Phone: (608) 266-2353