FORM USE OF VEHICLE FOR DELIVERY

Please write report to complete

Date : .........../............./.............. Start form factory time : ........ ...............

Car No : ............. ............... Car No : ... ............... line : ................... Kilometer start ( Out KM ) : ........ ............... Km.

Driver name 1 : ............. ............... kilometer arival ( In KM ) : ........ ............... Km.

Driver name 2 : ............. ............... Total Kilometer : ........ ............... Km.

No Shop Name In Time Out Time KM Head of Branch Remark

Check system of tracking Remark

1 Alarm Ring Quiet

2 Status of machine ready Can't use

3 Download data Normal Can't download data

4 Status car Normal Abnormal

Volume of gasoline Fuel up gasoline (Qty) .............................. ltr Volume of gasoline

Before start form factory arrival factory

Not fuel

Peralatan Pabrik Keluar / Pcs Masuk / Pcs Driver name ......................../.......................... Signature
Equepment factory Out / Pcs In/Pcs

Blue rack high

Head of Dept Name ......................../.......................... Signature

Blue rack short

Cooljel
Blue foam box
 CHECKLIST KILOMETERS OPERATIONS VEHICLE `

Month CAR No : ..............................

Fuel up
Driver Kilometer Volume of Gasoline Checked
Gasoline
No Date Destination
( Ltr ) Security /
Name / Initials Start Arrival Total Out Factory In Factory GA / Initials
( Ltr ) Initials

10

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 `

Bulan Car No : ..............................

Fuel up
Driver Kilometer Destination Volume of Gasoline Diperiksa
No Tanggal Gasoline
Nama Start Arrival Total Out Factory In Factory ( Ltr ) Security GA

10

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 FORMULIR PENGGUNAAN KENDARAAN UNTUK DELIVERY
FORM USE OF VEHICLE FOR DELIVERY

Silahkan Tulis Laporan Dengan Lengkap

Please write report to complete

Tanggal : .........../............./.............. Berangkat dari pabrik ( waktu ) : ........ ...............

Date Start form factory time
No Plat Kendaraan : ............. ............... No Kendaraan : ... ............... Jalur : ................... Kilometer awal ( Out KM ) : ........ ............... Km.
Car No Car No line Kilometer start ( Out KM )
Nama Supir 1 : ............. ............... Kilometer akhir ( In KM ) : ........ ............... Km.
Driver name 1 kilometer arival ( In KM )
Nama Supir 2 : ............. ............... Total Kilometer : ........ ............... Km.
Driver name 2 Total Kilometer

Nama Toko Jam Datang Jam Keluar KM Kepala Cabang Keterangan

No
Shop Name In Time Out Time KM Head of branch Remark

Cek Sistem pelacak / GPS Keterangan

Check system of tracking Remark
1 Alarm Bunyi Diam
Alarm Ring Quiet
2 Status Mesin Siap Tidak dapat digunakan
Status of machine ready Can't use
3 Download data Normal Tidak bisa
Download data Normal Can't download data
4 Status kendaraan Normal Tidak Normal
Status car Normal Abnormal

Banyak BBM Pengisian BBM .............................. ltr Banyak BBM

Volume of gasoline Fuel up gasoline (Qty) Volume of gasoline
Sebelum beragkat dari pabrik Tiba di Pabrik
Before start form factory Tidak mengisi BBM arrival factory
Not fuel

Peralatan Pabrik Keluar / Pcs Masuk / Pcs Nama Driver ......................../.......................... Tanda tangan
Equepment factory Out / Pcs In/Pcs Driver name Signat
Rak Biru tinggi
Blue rack high
Rak biru pendek Nama Kepala Dept ......................../.......................... Tanda tangan
Blue rack short Head of Dept Name Signature
Jel Dingin
Cooljel
Box busa biru
Blue foam box
 FORMULIR PENGGUNAAN KENDARAAN OPERASIONAL

Silahkan Tulis Laporan Dengan Lengkap

Please write report to complete

Tanggal : .........../............./.............. Berangkat dari pabrik ( waktu ) : ........ ...............

Date Start form factory time
No Plat Kendaraan : ............. ............... Kilometer awal ( Out KM ) : ........ ............... Km.
Car No
Nama Supir 1 : ............. ............... Kilometer akhir ( In KM ) : ........ ............... Km.
Driver name 1 kilometer arival ( In KM )
Nama Supir 2 : ............. ............... Total Kilometer : ........ ............... Km.
Driver name 2 Total Kilometer

Nama Toko Jam Datang Jam Keluar KM Kepala Cabang Keterangan

No
Shop Name In Time Out Time KM Head of branch Remark

Cek Sistem pelacak / GPS Keterangan

Check system of tracking Remark
1 Alarm Bunyi Diam
Alarm Ring Quiet
2 Status Mesin Siap Tidak dapat digunakan
Status of machine ready Can't use
3 Download data Normal Tidak bisa
Download data Normal Can't download data
4 Status kendaraan Normal Tidak Normal
Status car Normal Abnormal

Banyak BBM Pengisian BBM .............................. ltr Banyak BBM

Volume of gasoline Fuel up gasoline (Qty) Volume of gasoline
Sebelum beragkat dari pabrik Tiba di Pabrik
Before start form factory Tidak mengisi BBM arrival factory
Not fuel

Peralatan Pabrik Keluar / Pcs Masuk / Pcs Nama Driver ......................../.......................... Tanda tangan
Equepment factory Out / Pcs In/Pcs Driver name Signat
Rak Biru tinggi
Blue rack high
Rak biru pendek Nama Kepala Dept ......................../.......................... Tanda tangan
Blue rack short Head of Dept Name Signature
Jel Dingin
Cooljel
Box busa biru
Blue foam box
 CHECKLIST KILOMETERS VEHICLE

NAME USER :

VICHELE TYPE :

POLICE NO. :

MONTH :

START FINISH FUEL ADDED

TOL PARKING
No Date DESTINATION REMARK
Time Km Time Km Km Litres Rp
Rp Rp

10

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 START FINISH FUEL ADDED
TOL PARKING
No Date DESTINATION REMARK
Time Km Time Km Km Litres Rp
Rp Rp

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Prepared by Approved by

( ............................) ( ............................)