Complete information is required - please complete every blank.
I understand that all points, awards and money earned will be paid to the driver. I further understand that as an independent contractor I am solely responsible for compensating my employees, agents or pit crew members. I certify that I have not been convicted of an illegal drug violation during the one year prior to the date of this application. If form is not complete or if incorrect payment is received, the form will be returned to you for correction and your licensing to race will be delayed. Thank you and best of luck in the 2001 racing season.