Date of application / / mm/dd /yyyy

Position(s) Applied for

Last Name First Name Middle

List your addresses of residency for the past 3 years.

Current Address City State -- AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip How long? yrs

Current Phone (ex. 5551234567)

Previous Address City State -- AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip How long? yrs

Previous Address City State -- AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip How long? yrs

Previous Address City State -- AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip How long? yrs

Do you have the legal right to work in the United States? Yes No

Date of Birth / / (mm/dd/yy) Can you provide proof of your age? Yes No
(Required for Commercial Drivers)

Have you worked for Igo Oil Field Service, Inc. before? Yes No Where?

Dates: From / / (mm/dd/yy) To / / Rate of Pay $

Position Reason for leaving

Are you employed? Yes No If not, how long since leaving last employment?

Who referred you? Rate of pay expected $

Is there any reason you might be unable to perform the functions of the job for which you applied as
described in the job description? Yes No

If yes, explain (optional)

Employment History

All driver applicants to drive interstate commerce must provide the following information on all employers during the preceding 3 years.
List complete mailing address, street number, city, state, and zip code.

Applicants to drive a commercial vehicle* in intrastate commerce shall also provide an additional 7 years' information on those
employers for whom the applicant operated such vehicle. (NOTE: List employers in reverse order starting with the most recent.
If more room is needed please print the application provided above and mail to Igo Oil Field Service.)

*Includes vehicle having a GVWR of 26,001 lbs or more, vehicles designed to transport 15 or more passengers, or any size
vehicle used to transport hazardous materials in a quantity requiring placarding.

Most Recent Employer:

Name Contact Person

Address City State -- AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip

Phone Date of Employment: From January February March April May June July August September October November December 2004 2003 2002 2001 2000 1999 1998 1997 To January February March April May June July August September October November December 2004 2003 2002 2001 2000 1999 1998 1997

Position Held Salary/Wage $

Reason for leaving

Previous Employer:

Name Contact Person

Address City State -- AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip

Phone Date of Employment: From January February March April May June July August September October November December 2004 2003 2002 2001 2000 1999 1998 1997 To January February March April May June July August September October November December 2004 2003 2002 2001 2000 1999 1998 1997

Position Held Salary/Wage $

Reason for leaving

Previous Employer:

Name Contact Person

Address City State -- AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip

Phone Date of Employment: From January February March April May June July August September October November December 2004 2003 2002 2001 2000 1999 1998 1997 To January February March April May June July August September October November December 2004 2003 2002 2001 2000 1999 1998 1997

Position Held Salary/Wage $

Reason for leaving

Previous Employer:

Name Contact Person

Address City State -- AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip

Phone Date of Employment: From January February March April May June July August September October November December 2004 2003 2002 2001 2000 1999 1998 1997 To January February March April May June July August September October November December 2004 2003 2002 2001 2000 1999 1998 1997

Position Held Salary/Wage $

Reason for leaving

Experience and Qualifications - Other

Have you ever been denied a license, permit or privilege to operate a motor vehicle? Yes No

Has any license, permit or privilege ever been suspended or revoked? Yes No

IF THE ANSWER TO EITHER A OR B IS YES, SUBMIT DETAILED INFORMATION TO IGO OIL FIELD SERVICE, INC.

Driving Experience If none, write none

List state operated in the last 5 years

Show special courses or training that will help you as a driver:

Which safe driving awards do you hold and from whom?

Accident Record

Accident record for past 3 years or more (if none, write none)

Traffic convictions and forfeitures for the past 3 years (other than parking violations). If none, write none.

Education
Highest grade completed 1 2 3 4 5 6 7 8 9 10 11 12 College 0 1 2 3 4

Last School Attended: Name City

For this application to be completed you must print the Signature Page, complete the information requested,
sign and date the signature page and mail it to Igo Oil Field Service, P.O. Box 1311, Douglas, WY 82633.

Thank you for your application.