[Company Logo][Company Name]
- Ref. No.:
- [Reference Number]
- Date and Time of Issue:
- [DD/MM/YYYY] [HH:MM]
- Issue Type:
- Permanent allotment / Pool vehicle / Temporary replacement
1. Employee and Driving Licence
| Employee Name | [Employee Name] |
|---|
| Employee ID | [Employee ID] |
|---|
| Designation | [Designation] |
|---|
| Department / Territory | [Department] |
|---|
| Driving Licence No. | [Licence Number] |
|---|
| Licence valid till | [DD/MM/YYYY] |
|---|
| Vehicle classes covered | [Classes] |
|---|
| Licence copy verified by Admin: Yes / No | |
|---|
2. Vehicle Details
| Asset ID | Make / Model / Colour | Registration No. | Chassis No. | Engine No. | Fuel Type |
|---|
| [Asset ID] | [Make / Model / Colour] | [Registration Number] | [Chassis Number] | [Engine Number] | Petrol / Diesel / CNG / EV |
3. Vehicle Documents
| Document | Number | Valid Till | Copy in Vehicle |
|---|
| Registration Certificate (RC) | [RC Number] | [DD/MM/YYYY] | Yes / No |
| Insurance policy | [Policy Number] | [DD/MM/YYYY] | Yes / No |
| PUC certificate | [PUC Number] | [DD/MM/YYYY] | Yes / No |
| Permit / fitness (if applicable) | [Number] | [DD/MM/YYYY] | Yes / No |
4. Condition at Handover
| Odometer reading | [Kilometres] km |
|---|
| Fuel / charge level | [Level] |
|---|
| Next service due at | [Kilometres] km / [DD/MM/YYYY] |
|---|
| Check Point | Condition | Remarks |
|---|
| Body, paint and glass | OK / Scratches / Dents | [Remarks] |
| Tyres including spare | OK / Worn | [Remarks] |
| Lights, horn, wipers, mirrors | OK / Faulty | [Remarks] |
| Interior and seats | OK / Damaged | [Remarks] |
| Tools, jack, first-aid kit, helmet (two-wheeler) | Present / Missing | [Remarks] |
| Keys issued | [Number] keys | [Remarks] |
5. Conditions of Use
- The vehicle is to be used for official purposes and personal use only as permitted by the vehicle policy.
- Only I will drive the vehicle unless another licensed employee is authorised in writing.
- I will follow traffic rules, wear a seat belt or helmet, and not drive under the influence of alcohol or drugs or while using a mobile phone.
- Traffic fines incurred while the vehicle is with me will be my responsibility as per company policy.
- In case of an accident, I will inform Admin and the insurer immediately and follow the accident reporting procedure.
- I will maintain a trip log, get servicing done on time through approved workshops and keep the vehicle clean and secure.
- I will return the vehicle with all documents, keys and accessories when asked or on exit.
I confirm that I have received the vehicle described above, along with its documents and keys, in the condition recorded, and I agree to the conditions of use.
Received by
[Employee Name]Date:
[Date]Issued by
[Admin Name]Administration / Fleet
Date:
[Date]Approved by
[Reporting Manager]Date:
[Date]