49 C.F.R. § 391.65
(a) A motor carrier may employ a driver who is not a single-employer driver, as defined in § 390.5, of that motor carrier without complying with the generally applicable driver qualification file requirements in this part, if—
(2) That other motor carrier certifies that the driver is fully qualified to drive a commercial motor vehicle in a written statement which—
(vii) Is substantially in accordance with the following form:
____________________(Name of driver)
____________________(SS No.)
____________________(Signature of driver)
I certify that the above named driver, as defined in § 390.5, is a single-employer driver driving a commercial motor vehicle operated by the below named carrier and is fully qualified under part 391, Federal Motor Carrier Safety Regulations. His/her current medical examiner's certificate expires on ______(Date).
This certificate expires:
(Date not later than expiration date of medical certificate)
Issued on______(date)
Issued by__________
(Name of carrier)
(Address)
(Signature)
(Title)
(b) A motor carrier that obtains a certificate in accordance with paragraph (a)(2) of this section shall:
[41 FR 36656, Aug. 31, 1976, as amended at 53 FR 18057, May 19, 1988; 60 FR 38745, July 28, 1995; 63 FR 33278, June 18, 1998; 67 FR 61824, Oct. 2, 2002; 78 FR 58483, Sept. 24, 2013]