Form Haz-44 - Application For A Hazardous Materials Endorsement Page 2
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2Federal Disqualifying Criminal Offenses for Hazardous Materials Endorsement
New York State’s standards for disqualification are more stringent than the federal standards. Refer to NYS DMV form HAZ-11 for
NOTE:
more information.
Part A: Permanently Disqualifying Criminal Offenses
A driver will be permanently disqualified from holding a hazmat endorsement if he or she was convicted (or found not guilty by reason of
insanity) for any of the following felonies:
a) Espionage
h) Murder
b) Sedition
i) Making any threat, or maliciously conveying false information
knowing the same to be false, concerning the deliverance,
c) Treason
placement, or detonating of an explosive or other lethal device
d) A federal crime of terrorism as defined in 18 U.S.C. 2332b(g),
in or against a place of public use, a state or government facility,
or a state law that is comparable
a public transportation system, or an infrastructure facility.
e) A crime involving a transportation security incident
j) Violations of the Racketeer Influenced and Corrupt Organizations
f) Improper transportation of a hazardous material under
Act, 18 U.S.C. 1961, et seq., or a state law that is comparable,
49 U.S.C. 5124 or a state law that is comparable
where one of the predicate acts found by a jury or admitted by the
g) Unlawful possession, use, sale, distribution, manufacture,
defendant, consists of one of the offenses listed in this section
purchase, receipt, transfer, shipping, transporting, import, export,
k) Conspiracy or attempt to commit any of these crimes
storage of, or dealing in an explosive or explosive device
Part B: Interim Disqualifying Offenses
A driver will be disqualified from holding a hazmat endorsement if he or she was convicted (or found not guilty by reason of insanity) within
the previous seven years, or was released from prison in the last five years, for any of the following felonies:
a) Unlawful possession, use, sale, manufacture, purchase,
i) Kidnapping or hostage taking
distribution, receipt, transfer, shipping, transporting, delivery,
j) Rape or aggravated sexual abuse
import, export of, or dealing in a firearm or other weapon
k) Assault with intent to murder
b) Extortion
l) Robbery
c) Dishonesty, fraud, or misrepresentation, including identity fraud
m) Fraudulent entry into a seaport as described in 18 U.S.C. 1036,
d) Bribery
or a comparable State law
e) Smuggling
n) Violations of the Racketeer Influenced and Corrupt
f) Immigration violations
Organizations Act, 18 U.S.C. 1961, et seq., or a state law that is
comparable, other than the violations listed in item (j) of Part A
g) Distribution of, intent to distribute, or importation of a controlled
substance
above (“Permanently Disqualifying Criminal Offenses”)
h) Arson
o ) Conspiracy or attempt to commit any of these crimes
Part C: Under Want or Warrant
A driver will be disqualified from holding a hazmat endorsement if he or she is wanted or under indictment in any civilian or military
jurisdiction for a felony listed under Part A or Part B, until the want or warrant is released.
Part D: Read each statement below, then check the appropriate box.
1. Have you been convicted, or found not guilty by reason of insanity, of any disqualifying crime listed in Part A,
Yes
No
in any jurisdiction, military or civilian, during the 7 years before the date of this application?
2. Have you been released from incarceration in any jurisdiction, military or civilian, for committing any
Yes
No
disqualifying crime listed in Part A, during the 5 years before the date of this application?
3. Have you been convicted, or found not guilty by reason of insanity, of any disqualifying crime listed in Part B,
Yes
No
in any jurisdiction, military or civilian?
4. Are you wanted or under indictment for any disqualifying crime listed in Part C?
Yes
No
Yes
No
5. Have you ever been adjudicated as lacking mental capacity, or involuntarily committed to a mental institution?
READ THE INFORMATION AND ANSWER THE QUESTIONS ABOVE BEFORE SIGNING BELOW.
I have disclosed any and all information with this application related to disqualifying crimes committed, as required by
CERTIFICATION:
federal regulation 49 CFR 1572.5(b). I understand my continuing obligation to disclose to TSA within 24 hours if I am convicted or found
not guilty by reason of insanity of any disqualifying crime, or if I am adjudicated as a mental defective or committed to a mental institution,
while I have a hazardous materials endorsement for a CDL. 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 a hazardous materials endorsement.
X
DATE
SIGN HERE
PAGE 2 OF 2
HAZ-44 (7/17)
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