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List Previous Address If Less Than 1 Year (Street Address, City, State, and Zip Code)

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DOT Safety Sensitive Position (Yes or No)

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I agree and give consent to the company for obtaining necessary information for verification/investigation of my background; MVR , including personal and employment references, State, Federal, and or local records/data repositories, and entities that govern The FMCSA/DOT Rules and Regulations and Defender company policies. Engulf Waste LLC. will share the information and reports they deem necessary. I certify the application submitted is complete and accurate to the best of my knowledge. I also understand falsifying answers or statements made by me on this application or related documents are sufficient for rejection of my application. I have read the above statements, I understand them, and agree. Engulf Waste LLC. has my consent along with my full cooperation during the procurement process. I understand submitting an application is not a guarantee of Employment with the company and employment are contingent pending results of background and/or Hiring Manager. By providing your name below you agree to authorizing verification . Engulf Waste LLC. is an equal opportunity employer. PLEASE Sign/Type Your Name Below.

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