DRIVER RECORD REPORT FOR NEW JERSEY

REPORT DATE: 11/21/2003

REPORT FOR: ………………………

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LICENSEE

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LICENSE NUMBER DOB DESCRIPTION SSN

………………………………… 01/24/60 M HT: 6’00 EYE: HR:

ISSUED EXPIRED CLASS RESTRICTIONS STATUS

09/26/01 01/24/08 A A ELIGIBLE

MISCELLANEOUS INFORMATION

LIC STATUS ELIGIBLE

CDL CLASS A CDL COMBINATION VEHICLE >26K, TOW >10K

CDL ENDMT H HAZARDOUS MATERIALS

CDL RESTR A CORRECTIVE LENSES

ORIGINAL ISSUE DATE 01/16/96

ORIGINAL CDL ISSUE DATE 09/26/01

DRIVING RECORD HISTORY

TYPE VIOL REI DESCRIPTION PTS CODE

CLRR CLEAR RECORD

END OF REPORT