Vehicle Use Record printable pdf download

Vehicle Use Record

Note: Vehicle records must be maintained

for audit purposes. It is

important that all of the required information be included on the record

and that it be reviewed and signed by an appropriate individual within the

department. Incomplete and inappropriate entries will result in audit

criticism. Completed

forms must be maintained

in department

records for three (3) complete fiscal years.

Vehicle Use Record

MOIYR

DEPARTMENT

VEHICLE LOCATION

TAG NO.

VEHICLE MAKEIYEAR

I certify that I have reviewed the Vehicle Use Record and all

Drivers of this vehicle are in possession of a valid operator's license.

ALL DRIVERS MUST POSSESS A VALID OPERA TOR'S LICENSE

SEAT BELTS MUST BE USED AND SPEED LIMITS OBSERVED

Name/Title/Date (Responsible Department Reviewer)

FA-UF-VUR 7/99

Time

Mileage

I certify that my Driver's

Out

Print Driver Name

License is valid and trip

information is accurate.

Date

0 rie:in atio nlDestina tion

Purpose of Trip

Driver's signature below:

Vehicle Use Record