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Mechanic Group

Mechanic Group

Mechanic Group

 
New Driver MVR Evaluation Form

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Driver MVR Evaluation Form
Driver Name
Date
License Status
DMV Authorization form signed and on file

Warning! Do not complete this form unless the employee or prospective employee has signed an authorization that allows you to evaluate his motor vehicle driving history
Date MVR Report was run
Completed By
A. Years Driving Points Answer
Less than 4 2
5 or more 0
9 or more -1
TOTAL  
B. Work History
(years with company)		 Points Answer
Up to 3 0
4 to 6 -1
7 or more -2
TOTAL  
C. Number of Motor Vehicle Accidents
in the last 5 years 		Points Answer
None 0
1 2
2 4
3 or More 10
TOTAL  
D. Driver Safety Program / Initiative Points Answer
Defensive Driving 4 Hour Course -1
Defensive Driving 8 hour Course -4
Driver Safety 8 Hour Course -4
Driver Safety 40 Hour Course -8
TOTAL  
If More than one violation add a PVV for each violaion
E. Serious moving violations (within last 3 years) Points Answer
Failure to Obey Traffic Device 1
Failure to Signal or Yield 1
Operating a telecommunication device 1
Driving without a seat belt 1
Improper Lane Usage 1
Tailgating 2
Driving without a license or with a suspended license 2
Failure to Stop after traffic collission 3
Speeding 3
Speeding (30MPH or more over limit) 6
DUI, OUI, Reckless Driving, Street Racing, Vehicular Homicide 15
Refusing Substance Test 15
Eluding a Police Officer 15
Reckless Driving 15
Speeding Contest (racing) 15
Hit and Run 15
Aggravated Assault with Motor Vehicle 15
TOTAL  
GRAND TOTAL SCORE  

Total Points Employee Grade Score
0-6 Acceptable Driver
7-10 Driver needs management approval
11 and above Employee cannot drive a vehicle for any reason