Driver Application

Step 1 of 7

AUTHORIZATION TO OBTAIN MOTOR VEHICLE RECORD

VA Code 46.2-208 classifies driver abstracts as privileged records and limits the release of an abstract of a driver's record to only an employer, potential employer, or authorized agent who has been authorized in writing by such driver to obtain the driver's record.

THE UNDERSIGNED DOES HEREBY ACKNOWLEDGE AND CERTIFY AS FOLLOWS:

  1. That the undersigned gives his or her consent to the release of their driving record ("MVR") for review by H & T Transit, LLC
  2. That the undersigned authorizes his or her driving record to be periodically obtained and reviewed for the purpose of initial and continued employment.
  3. That the undersigned gives his or her consent to the release of their driving record (“MVR") for review by NANSEMOND INSURANCE AGENCY, INC.
  4. That the undersigned understands that his or her driving record may also be provided to insurance carriers for the purpose of determining the insurability of certain hazards.
  5. That the undersigned authorizes release of and discussion of his or her driving record between potential employees and Nansemond Insurance Agency and any insurance company.
Print Full Name As It Appears On Your License
License Number & State(Required)
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