Vehicle Request Form

Responsibility

• The responsibility of this vehicle/equipment shall be charged to the driver/operator and the requesting department.
• The vehicle/equipment should not be operated or driven by anyone other than driver listed above.
• Neglect and/or abuse to vehicle equipment will be charged to the requesting department.
• The vehicle/equipment shall be returned clean (all trash and/or equipment removed) upon return.
• Any mechanical discreprancies shall be noted with the Fleet Manager during vehicle/equipment check-in.

Date of Request (Request Must Be Submitted at Least Three Days in Advance)

Name of Driver (Must Be Certified to Operate Vehicle)

Department

Email Address

Work Phone Number

Date of Certification

Destination

Number of Passengers

Purpose of Trip

Departure Date

Departure Time

Return Time

Type of Vehicle Required