Driver Application

Personal Information

First Name *

Last Name *

Email Address *

Phone Number *

Current City & State of Residence

Market & Role Preference

Vehicle type(s) you can drive *

Preferred Schedule

Driving License & Credentials

Driver's License Number *

State Issued

License Class *

License Expiry Date

Endorsements Held

Do you have a current, valid CDL?

Yes No

Clean driving record (no major violations in last 3 years)?

Yes No

Any DUI or reckless driving conviction?

Yes No

Airport Security Certification

Are you TSA Certified?

Yes No

Great - which TSA certification do you hold?

STA - Security Threat Assessment TWIC - Transportation Worker ID Credential

STA Details

STA Number *

Issued By / Airport Authority

STA Start Date *

STA Expiry Date *

TWIC Details

TWIC Card Number *

Issuing TSA Office / Port Authority

TWIC Issue Date *

TWIC Expiry Date *

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Scan or Upload Your Documents

To make uploading easier on your phone, we can access your camera to scan documents or your photo gallery to select existing photos.

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DEPARTMENT OF HOMELAND SECURITY

Transportation Security Administration

APPLICATION FOR NEW OR RENEWAL
SECURITY THREAT ASSESSMENT (STA)

OMB Control Number 1652-0040 · Expiration Date: 01/31/2028
TSA Form 419F (2/25) · All fields to be completed unless otherwise noted.

Why is this required? As an indirect air carrier (IAC), Neonline Logistics is required under 49 CFR §§ 1548.15 and 1548.16 to ensure all personnel with unescorted access to air cargo have successfully completed a Security Threat Assessment before performing those functions.

SECTION I - General Information

Current STA Number (Renewals Only)

Application Type

Current Employer Name *

Employer Corporate Address *

City *

State *

Zip *

Employer Phone Number *

Are you currently residing in the United States? *

Yes No

Social Security Number *

Date of Birth *

Legal Name - As it appears on government-issued photo ID

First Name *

Middle Name

Last Name *

Suffix

Previous Name Used (if applicable)

First Name

Middle Name

Last Name

Suffix

Previous Name Used (if applicable - 2nd)

First Name

Middle Name

Last Name

Suffix

Email Address

Daytime Phone Number *

Sex *

Male Female

Country of Citizenship *

Naturalization Date (if applicable)

Place of Birth - City *

Place of Birth - State

Place of Birth - Country *

I-94 Number (if applicable)

Alien Registration Number (if applicable)

Naturalization Certificate Number (if applicable)

US Passport / Certificate of Birth Abroad Number (if applicable)

Current Mailing Address

Street Address *

City *

State

Country *

Zip Code

Current Residential Address (or check if same as mailing) Same as Mailing Address

When did you move to your current address? *

Street Address

City

State

Zip

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5-Year Address History Required

TSA requires a complete residential address history for the past 5 years. Please list every address you have lived at since . Do not include PO Boxes.

Previous Residential Addresses (last 5 years - no PO Boxes)

Address 1

Start Date

End Date

City

State / Zip

SECTION II - Applicant Acknowledgement

The information I have provided on this application is true, complete, and correct to the best of my knowledge and belief and is provided in good faith. I understand that a knowing and willful false statement, or an omission of a material fact, on this application can be punished by fine or imprisonment or both (see section 1001 of Title 18 United States Code), and may be grounds for denial of authorization.

Applicant Signature (Type full legal name to sign) *

Date *

Printed Name:

SECTION III - Employer Acknowledgement

I have authenticated the identity and work authorization of the individual for whom this STA application is being submitted by reviewing a Photo Identification issued by a government authority and work authorization documents as required under 49 C.F.R § 1540.203(b).

Employer Signature: Ashray Mehra — will be auto-signed upon submission.

Your STA application will be sent to joinus@neonlinelogistics.com. Neonline HR will countersign and submit to TSA on your behalf. Typically 3-5 business days.

Vehicle Information

Do you own your vehicle?

Yes No

Driving Experience

Years of Professional Driving Experience

Route Types

Describe your most recent driving experience

Experience with time-critical or medical freight?

Yes No

Experience with temperature-sensitive (Reefer) cargo?

Yes No

Compliance & Background

Willing to submit to a background check?

Yes No

Willing to submit to a drug screening?

Yes No

Authorized to work in the United States?

Yes No

Language Proficiency

English (Fluent) Spanish (Fluent) Spanish (Conversational) Other

References

Reference 1 - Full Name

Reference 1 - Relationship

Reference 1 - Phone

Reference 1 - Email

Reference 2 - Full Name

Reference 2 - Relationship

Reference 2 - Phone

Reference 2 - Email

Resume & Additional Information

UPLOAD RESUME (Optional for Drivers)

PDF or Word document. Max 10MB.

Anything else you'd like us to know?

Application Received!