DRIVER’S TIME RECORD
Driver’s Name (print) __________________________ Employee No. ___________ Month _______________ Year _________
DRIVERS MAY PREPARE THIS REPORT INSTEAD OF “DRIVERS DAILY LOG” IF
INTERMITTENT DRIVERS
THE FOLLOWING APPLIES:
Shall complete this form for 7 days
* Operates within 100 air-mile radius for CDL or 150 mile radius for non CDL drivers.
preceding any day driving is
* Returns to headquarters and is released from work within 12 consecutive hours.
performed.
* At least 8 consecutive hours off duty separate each 12 hours of duty.
This includes the preceding month.
Start Time
End Time
Total
Driving
Truck
Date
Headquarters
“All Duty”
“All Duty”
Hours
Hours
Number
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
To be prepared monthly by each DOT certified driver unless time record is exclusively kept on Driver’s Daily Log.
Indicate “days off”. Check box if no driving is performed during this month and the first 7 days of the following month.
Mail this report to your Division Manager of Administration.
Page 11
Part 395 - Hours of Service of Drivers