Commercial Driver Training Employer Certification

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Commercial Driver Training Employer Certification

Employer ID number

This is to certify that:

Driver license number

Last name

First

Middle initial

Residence address City

County

Phone State WA

ZIP code

Date of birth

Sex: Male Female Email

Has the skills and required training to safely operate: Class A Class B Class C vehicles on public highways.

Employer name

UBI number

Employer address

City

County

State

ZIP code

Contact name

Phone

Employer email

I certify under penalty of perjury under the laws of the state of Washington that the foregoing is true and correct.

Date and place

X Driver signs here.

Signature of driver

DLE-520-339 (R/3/18) WA

Date and place DOL USE ONLY:

Authorization #

LSO #

PRINT OR TYPE name of authorized employer representative

X Authorized employer representative signs here.

Signature of authorized employer representative

Driver or training provider must submit this original certification to the Department of Licensing for license issuance.

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