Form SBTS-601 "Personal History of Commercial Driver Training School Owner or Manager" - North Carolina

What Is Form SBTS-601?

This is a legal form that was released by the North Carolina Department of Transportation - Division of Motor Vehicles - a government authority operating within North Carolina. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on February 1, 2000;
  • The latest edition provided by the North Carolina Department of Transportation - Division of Motor Vehicles;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form SBTS-601 by clicking the link below or browse more documents and templates provided by the North Carolina Department of Transportation - Division of Motor Vehicles.

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Download Form SBTS-601 "Personal History of Commercial Driver Training School Owner or Manager" - North Carolina

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SBTS-601
SBTS-601 (Rev. 02/00)
North Carolina Division of Motor Vehicles
School Bus and Traffic Safety Section
PERSONAL HISTORY OF COMMERCIAL DRIVER TRAINING SCHOOL OWNER OR MANAGER
This form must be submitted by ALL owners, partners, associates, corporate directors, officers and managers, who have not submitted an instructor’s
application, and attached to the "Commercial Driver Training School Application for License." Information furnished on this form shall be confidential
and shall be used only by the Division.
Name of owner, partner, associate corporate director, officer or manager
Last:
First:
Middle:
Application Date:
Mo. Day Year
Home Address:
City:
State:
Expiration Date:
Zip Code:
Home Phone (Area Code):
Mo. Day Year
Current N.C. Driver License No.
Name of commercial driver training school you own or manage:
Address of School:
City:
Zip Code:
Business Phone
Place of Birth (City)
Place of Birth (State)
Height
Weight
Color of Eyes
Color of Hair
Sex
Date of Birth
EDUCATION AND MILITARY SERVICE
Education (Circle the highest grade completed)
Grade School
High School
College
Other (Please specify)
1
2
3
4
5
6
7
8
9
10
11
12
1
2
3
4
5
6
Have you successfully completed a course in Driver Education
College or University
Location of College or University
at an accredited college or university?
Yes
No
(If answer is yes complete the following spaces.)
If so, indicate certificate number
Do you hold a N.C. Teaching Certificate?
Yes
No
Dates of Service:
Branch of Service
Type of Discharge
To/From
Are you a veteran?
Yes
No
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SBTS-601
SBTS-601 (Rev. 02/00)
North Carolina Division of Motor Vehicles
School Bus and Traffic Safety Section
PERSONAL HISTORY OF COMMERCIAL DRIVER TRAINING SCHOOL OWNER OR MANAGER
This form must be submitted by ALL owners, partners, associates, corporate directors, officers and managers, who have not submitted an instructor’s
application, and attached to the "Commercial Driver Training School Application for License." Information furnished on this form shall be confidential
and shall be used only by the Division.
Name of owner, partner, associate corporate director, officer or manager
Last:
First:
Middle:
Application Date:
Mo. Day Year
Home Address:
City:
State:
Expiration Date:
Zip Code:
Home Phone (Area Code):
Mo. Day Year
Current N.C. Driver License No.
Name of commercial driver training school you own or manage:
Address of School:
City:
Zip Code:
Business Phone
Place of Birth (City)
Place of Birth (State)
Height
Weight
Color of Eyes
Color of Hair
Sex
Date of Birth
EDUCATION AND MILITARY SERVICE
Education (Circle the highest grade completed)
Grade School
High School
College
Other (Please specify)
1
2
3
4
5
6
7
8
9
10
11
12
1
2
3
4
5
6
Have you successfully completed a course in Driver Education
College or University
Location of College or University
at an accredited college or university?
Yes
No
(If answer is yes complete the following spaces.)
If so, indicate certificate number
Do you hold a N.C. Teaching Certificate?
Yes
No
Dates of Service:
Branch of Service
Type of Discharge
To/From
Are you a veteran?
Yes
No
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SBTS-601
EMPLOYMENT
List employment experience for last 5 years, most recent first (use additional paper if extra space is needed).
Name of Firm
Address of Firm
Dates Employed:
Kind of Work
Reason for Leaving
To/From
Name of Firm
Address of Firm
Dates Employed:
Kind of Work
Reason for Leaving
To/From
Name of Firm
Address of Firm
Dates Employed:
Kind of Work
Reason for Leaving
To/From
QUESTIONS
You must answer each of the following questions "Yes" or "No". All questions answered "Yes" must be explained in the explanation area provided on the back side
of application.
1.
Have you ever been known by any name other than the one shown on the personal history?
Yes
No
2.
Have you ever been convicted of a felony?
Yes
No
3.
Have you ever been convicted of murder without malice with a motor vehicle?
Yes
No
4.
Have you ever been convicted of negligent homicide?
Yes
No
5.
Have you ever been convicted of driving under the influence of intoxicating liquors?
Yes
No
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SBTS-601
6.
Have you ever been convicted of driving under the influence of drugs?
Yes
No
7.
Have you ever been convicted of leaving the scene of a traffic accident involving death or personal injury?
Yes
No
8.
Have you ever been convicted of perjury or making of any false statements relating to any portion of the N.C. Motor Vehicle Law?
Yes
No
9.
Have you ever been convicted of any traffic violations other than parking violations?
Yes
No
10.
Have you ever convicted of any crime involving moral turpitude?
Yes
No
11.
Have you ever been convicted of any misdemeanor other than traffic violations?
Yes
No
12.
Are you now involved with any charges or court proceedings relating to the matters stated in questions 2, 3, 4, 5, 6, 7, 8, 9, 10, or 11?
Yes
No
13.
Has your license to drive in N. C. or any other state, ever been refused, cancelled, suspended, or revoked?
Yes
No
14.
Has your commercial driver training school instructor’s license ever been denied, cancelled, suspended, or revoked?
Yes
No
15.
Are there any motor vehicle accident judgments pending against you as yet unsatisfied?
Yes
No
16.
Have you given driver training instruction for compensation or hire within the past 12 months?
Yes
No
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SBTS-601
Explanation of the previous questions answered "Yes" (Use additional plain paper if extra space iis needed)
1–½" x 1–½"
Glossy Photograph
-Head & Shoulders-
The undersigned swears (affirms) that he has read the entire foregoing personal history schedule; that he knows the contents thereof; and that all answers, statements and all other
matters contained therein are true in substance and in fact.
_________________________________________
Applicant’s signature
TO KNOWINGLY MAKE A FALSE STATEMENT OR CONCEAL A MATERIAL FACT IN THE APPLICATION IS A CRIMINAL OFFENSE, AND MAY RESULT IN THE
REVOCATION OF YOUR COMMERCIAL DRIVER TRAINING SCHOOL LICENSE.
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