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Washington State Driving Record Release
APPENDIX C
EMPLOYEE OR PROSPECTIVE EMPLOYEE REQUEST
That I, , am an employee or prospective employee of the company
named below and that I request a copy of my official Driving Record in the State
of Washington be released to my employer or prospective employer or their agent.
Authorization of employee or prospective employee for release of abstract of
driving record
______________________________________________________________________________
Signature Date WA License # or print full name and date of birth
EMPLOYER ATTESTATION
(A) That the company named below is an employer or prospective
employer of the above namedindividual and that I am a representative authorized
to bind said company.
(B) That Absolute
Background Search is acting as agent on
behalf of Premium Background Checks who is acting as agent on our behalf
to obtain the abstract of driver records of the above named individual. (C) That
abstracts of driver record shall be used exclusively to determine whether the
above named individual should be employed to operate a school bus or commercial
vehicle upon the public highways, and that no information contained therein
shall be divulged, sold, assigned, or otherwise transferred to any third person
or party. A commercial vehicle is defined as any vehicle the principal use of
which is the transportation of commodities, merchandise, produce, freight,
animals, or passengers for hire. (D) That the information contained in the
abstracts of driver records obtained from the Washington State Department of
Licensing shall be used in accordance with the requirements and in no way violate
the provisions of RCW 46.52.130, attached in part for easy reference.
Company
Name________________________________________________________
Address______________________________________________________________
Name (print)
Title______________________________________________________
Signature
Date________________________________________________________
This record must be maintained by the employer or prospective
employer for a period of not less thantwo (2) years from the last date above.
Failure to obtain all signatures or misuse of records obtained from the State of
Washington may result in prosecution under RCW 46.52.130.RCW 46.52.130 Abstract
of driving record -- Access -- Fees -- Penalty.
A certified abstract of the driving record shall be furnished
only to the individual named in the abstract, an employer or prospective
employer or an agent acting on behalf of an employer or prospective employer, …
Upon proper request, a certified abstract of the full driving record maintained
by the department shall be furnished to … the individual named in the abstract
or to an employer or prospective employer or an agent acting on behalf of an
employeror prospective employer of the named individual. The abstract, whenever
possible, shall include an enumeration of motor vehicle accidents in which
theperson was driving; the total number of vehicles involved; whether the
vehicleswere legally parked or moving; whether the vehicles were occupied at the
time of the accident; whether the accident resulted in any fatality; any
reported convictions, forfeitures of bail, or findings that an infraction was
committed based upon a violation of any motor vehicle law; and the status of the
person's driving privilege in this state. The enumeration shall include any
reports of failure to appear in response to a traffic citation or failure to
respond to a notice of infraction served upon the named individual by an
arresting officer. … Any employer or
prospective employer or an agent acting on behalf of an employer or prospective
employer receiving the certified abstract shall use it exclusively for his or
her own purpose to determine whether the licensee should be permitted to operate
a commercial vehicle or school bus upon the public highways of this state and
shall not divulge any information contained in it to a third party.
Release of a certified abstract of the driving
record of an employee or prospective employee requires a statement signed by:
(1) The employee or prospective employee that
authorizes the release of the record, and (2) the employer attesting that the
information is necessary to determine whether the licensee should be employed to
operate a commercial vehicle or school bus upon the public highways of this
state. If the employer or prospective employer authorizes an agent to obtain
this information on their behalf, this must be noted in the statement.
Any negligent violation of this section is a
gross misdemeanor. Any intentional violation of this section is a class C
felony.
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