Fm-12e - Travel Log For Permanently Assigned Vehicles
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1Total Miles
FM-12e
STATE OF NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION
Rate per Mile
Motor Fleet Management Division, Raleigh
Mileage Charge
TRAVEL LOG
Monthly Fee
$35.00
FOR PERMANENTLY ASSIGNED VEHICLES
Total Amount
Department
Agency
Dept./Off. No.
Fund No.
RCC No.
Vehicle No.
Individual Responsible for Vehicle:
Approval of Agency Head or Supervisor:
For Month Of
TRIP DATES
OFFICIAL TRAVEL
MILEAGE
From
To
Purpose of Trip
Signature
Out
In
Miles
Leave Return
Odometer
No. of
No. of Trip
Local Trips
Readings:
Beginning of Month
End of Month
Trips
Days
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Parent category: Miscellaneous