Copyright 2019 J. J. Keller & Associates, Inc. All rights reserved.
DRUG & ALCOHOL CLEARINGHOUSE
CONSENT FOR LIMITED QUERIES
NOTICE TO DRIVER: The Commercial Driver’s License (CDL) Drug & Alcohol Clearinghouse
is a federal database containing information about CDL drivers who have violated the Federal
Motor Carrier Safety Administration’s (FMCSA’s) drug or alcohol regulations in 49 CFR Part
382. Whether you have committed such a violation or not, each motor carrier for whom you
drive is required to check whether the Clearinghouse has any information about you, both at
the time of hire and annually. When conducting an annual inquiry, the motor carrier has the
option to request a “limited” report that only indicates whether the Clearinghouse has any
information about you. Before a motor carrier may request a limited report, they must have
your written authorization, per §382.701(b). This authorization may be valid for more than one
year. If a limited query ever reveals that the Clearinghouse has information about you, you will
be required to log in to the Clearinghouse website within 24 hours to grant electronic consent
for the motor carrier to obtain your full Clearinghouse record.
NOTICE TO MOTOR CARRIER: This consent form authorizes you to run a “limited query” to
check whether the Clearinghouse has information about the driver identified below. If it does,
then you must obtain a full Clearinghouse record within 24 hours, per §382.701(b). This
consent form must be retained until 3 years after the date of the last limited query you perform
for this driver, based on the authorization below.
AUTHORIZATION
I, ________________________________________________, hereby authorize
(Driver’s printed name)
(Name of motor carrier)
to conduct limited annual queries of the FMCSA’s Drug & Alcohol Clearinghouse,
to determine if a Clearinghouse record exists for me. This consent is valid from the
date shown below until my employment with the above-named motor carrier
ceases or until I am no longer subject to the drug and alcohol testing rules in 49
CFR Part 382 for the above-named motor carrier.
I understand that if any limited query reveals that the Clearinghouse contains
information about me, I must grant electronic consent within 24 hours, via the
Clearinghouse website, for the motor carrier to obtain my full Clearinghouse
record. Refusal to provide such consent will result in my removal from safety-
sensitive duties.
Driver’s Signature: _________________________________________________
ID Number: ______________________________ Date: __________________
