Thank you for using our service!
Please complete the following steps so we can complete your order:
This is for FMCSA covered employers. Please complete each section. After completing each section and submitting the form, a copy will be e-mailed to the e-mail you provide. Please have the prospective employee sign the form. Once signed, e-mail or fax the form back to us for processing. All previous DOT covered employers of the prospective employee for the past 3 years must be checked. If the prospective employee has more than one DOT covered previous employer to check, a new form must be completed for each. DOT requires separate forms and signatures for each previous employer. The following are the steps in detail.
1. Please complete each section and submit a separate form for each previous employer:
Section 1 is the information of the previous employer the prospective employee worked for.
Section 2 is the information on the prospective employee. Provide full name and SSN or the employee
ID number issed by the past employer.
Section 3 is your company information. Please provide a valid e-mail. Reports are reported by e-mail
and stored in your SAPA account. If you do not have a SAPA account please contact us.
2. Once you submit the information a form will immediately be e-mailed to you for the employee to sign. If you do not get the form within 2 minutes DO NOT SUBMIT IT AGAIN. Check your spam folder or contact us and we will re-send it out.
3. Print out the form and have your prospective employee sign it. DOT requires forms be signed by the employee. We can not process your request without a signature.
5. Once finished, your completed request will be sent back by e-mail to the address you provided. Forms are also uploaded to your SAPA account. Please note SAPA is not a backup and DOT requires you to keep a copy on file. SAPA is for convenience only.
or by phone at 760-244-6886.
Thank you! We appreciate your business!
Mobile Occupational Services, Inc.