Driver Information Authorization

Here’s the clean, semantic HTML fragment for the provided content (note: this is a form, not a job posting, but I’ve reformatted it according to your rules for structure and clarity):

Please complete the following driver information as part of your application.

Driver Information

Fields marked with an asterisk (*) are required.

First Name* Last Name* Date of Birth* Driver's License Number* State of Issue* Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Armed Forces Americas Armed Forces Europe Armed Forces Pacific Driver's License Upload*

Please upload a copy of your driver's license (under 2MB). Accepted file types: PDF, JPG, JPEG, TIF, TIFF, BMP, PNG.

Authorization & Consent

By submitting this form, you agree to the following:

• Authorize Jeff Lowe Plumbing, Heating & A/C to obtain a Department of Motor Vehicles (DMV) check on your driving record.
• Understand that your NYS Motor Vehicle driving record will be disclosed to the organization.
• Acknowledge that you may not be allowed to drive on behalf of Jeff Lowe Plumbing, Heating & A/C if your motor vehicle record is unsatisfactory per auto insurance underwriting requirements.
• Agree that if hired, this authorization allows your employer to request an updated MVR at any time during your employment.

Signature* Today's Date*