Previous Employment Alcohol and Drug Test Statement
§40.25(j) As the employer, you must also ask the employee whether he or she has tested positive, or refused to test, on any pre-employment drug or alcohol
test administered by an employer to which the employee applied for, but did not obtain, safety-sensitive transportation work covered by DOT agency drug
and alcohol testing rules during the past two years. If the employee admits that he or she had a positive test or a refusal to test, you must not use the employee
to perform safety-sensitive functions for you, until and unless the employee documents successful completion of the return-to-duty process. (see
§40.25(b)(5) and 9e))
The prospective employee is required by §40.25(j) to respond to the following questions:
Must be Read and Signed by Applicant
I agree and understand that any misrepresentations of information given above shall be considered and act of falsification.
I agree and understand that the employer or his agents may investigate my background to ascertain any and all information of concern to my employment is
factual.
I agree and understand that if I am hired, it will be on an at-will basis, meaning the company may terminate me at any time for any non-discriminatory reason.
I understand that I will begin work on a probationary basis.
This certifies that this application was completed by me, and that all entries on it and information in it are true and complete to the best of my knowledge.
