This document has been prepared for:  

This individual is currently employed or applying for employment with :   

On this Date:   

I have electronically received the related FMCSR PARTS that relate to my profession. I am aware these are accessible any time of day or night with my Username and Unique Password, and I understand it is my responsibility to review these PARTS as necessary to keep current on my job responsibilities. I also acknowledge that these are provided for my convenience, however they may not be the most current PARTS, and that I can always find the most current PARTS at:  http://www.ecfr.gov/cgi-bin/ECFR?page=browse