(1) VEHICLE REGISTRATION NUMBER (3) VEHICLE TYPE

(2) (4) DATE (5) FUEL CARD

DAILY VEHICLE
USE RECORD DEPARTMENT

DRIVER (Name)
PART I: (6) ODOMETER READING BEGINNING OF DAY AND ON THE END OF THE DAY
TRIP RECORD Start: End: Total km traveled
DRIVER (Signature)
(7) (8) (9) (10) (11) (12) (13)
TIME TRAVEL ODOMETER SIGNATURE OF
PURPOSE OF TRIP (INCLUDE DESTINATION) READING
POINT OF DEPARTURE AUTHORIZED TIME DRIVER
BY DEP ARR DEP ARR

(14) TOTAL NUMBER OF TRIPS MADE

(15) TOTAL TRAVEL TIME.

NOTE: BEFORE FIRST TRIP, PERFORM DAILY PREVENTIVE MAINTENANCE CHECK

 (19) COMMENTS
PART II: DRIVER'S DAILY PREVENTIVE MAINTENANCE CHECKLIST

(16) (17) (18)

PART II ACTION TAKEN MECHANIC

Driver check daily and take required action: CHECKED (see comments) REQUIRED

(20) DRIVER'S SIGNATURE

Brakes

Lights, signals, windshield wipers, horn

PART III: VEHICLE OPERATION
Clutch
(21) Report defects noted during operation of vehicle or any emergency road
Vehicle Cleanliness repairs made:

Engine oil level

Radiator coolant level

Tire condition and pressure (22) DRIVER'S SIGNATURE

Spear Wheel

Power steering fluid level PART IV: SERVICE

Automatic transmission fluid level (23) (24) (25)
FUEL ADDED OIL ADDED ODOMETER READING
Gauges and indicator lights
ltr gal cost ltr gal cost km mi
Fuel level

Battery

Engine compartment and surface under vehicle for leaks

First Aid Kit

(26) DRIVER(S) SIGNATURE(S)
Fire Extinguisher

Torch
(27) COMMENTS

CONDITION (report any irregular conditions such as dents or scratches)