Vehicle IN / OUT Form

Employee Information: ‫معلومات الموظف‬ Vehicle Information: ‫معلومات السيارة‬

Employee Name:__________________________ Vehicle Make: ___________________________

Velosi Badge No._______________________________ Model (Year): ___________________________

RPO/Dept.: _________________________ Plate No.:_______________________________

Work Location:___________________________ Velosi No.: ______________________________

Mobile No.: ______________________________ Color: __________________________________

‫ خروج من الشركة‬/ OUT Vehicle (Employee receive Vehicle from the Company)

Temporary Out / ‫تسليم مؤقت‬ Permanent Out / ‫تسليم دائم‬

Date: _______________ Time: ________________ KM Reading: _____________

‫دخول الى الشركة‬/ IN Vehicle (Employee return Vehicle to the Company)

Temporary IN / ‫استالم مؤقت‬ Permanent IN / ‫استالم دائم‬

Date: _______________ Time: ________________ KM Reading: _____________

Remarks of IN Vehicle: Vacation ‫اجازة‬ Maintenance ‫صيانه‬ Accident ‫حادث‬

‫ تاريخ العودة من االجازه‬Return date from Vacation _______________________*

Remarks:

Out / ‫خروج‬ IN / ‫دخول‬

How Is My Driving Sticker? How Is My Driving Sticker?
Client’s Sticker Client’s Sticker

Vehicle Checking Information (Admin, please fill below before you hand over/takeover the vehicle from employee):
 Out Vehicle / ‫ خروج‬IN Vehicle/ ‫دخول‬
Handing / Taking List Put Remarks (If Any)
(OK / Not OK) (OK / Not OK)
Car Documents:- ‫اوراق السياره‬
1.) Registration Book (3-Copies)
‫االستمارة‬
2.) Insurance(3-Copies) ‫التأمين‬
3.) Contract (3-Copies) ‫عقد االيجار‬
4.) Authority Letter (2-Copies) ‫تصريح‬
‫الموظف‬
Internal Condition of Vehicle:- ‫وضع السيارة الداخلي‬
1.) Air Condition ‫المكيف‬
2.) Radio & Tap Recorder ‫الراديو‬
3.) Rearview Mirror ‫المرائة الداخليه‬
4.) Remote Control ‫الريموت‬
5.) Fuel Tank Cap ‫باب البانزين‬
6.) Tires % ‫العجالت‬
7.) Cigarettes Light ‫الوالعه‬
External Condition of Vehicle:- ‫وضع السيارة الخارجي‬
8.) Velosi Logo ‫شعار الشركة‬
9.) Headlights & Indicators ‫المبات‬
‫واالشارات‬
10.) Wipers ‫المساحات‬
11.) Side Mirror ‫المرايات الجانبيه‬
12.) Windshield ‫الزجاج االمامي‬
13.) Rear Glass ‫الزجاج الخلفي‬
14.) Side Glass ‫زجاج االبواب‬
Safety Equipments of Vehicle: ‫ادوات االمان‬
15.) Air Pump ‫منفاخ الهواء‬
16.) Jumper Wire ‫كيبل اشتراك‬
17.) First Aid ‫حقيبة اسعافات‬
18.) Fire Extinguisher ‫طفاية حريق‬
19.) Towing Cable ‫كيبل سحب‬
20.) Tool Kit ‫عدة‬
21.) Jack & Wheel Spanner ‫مفتاح عجل‬
22.) Spare Tire ‫عجل احتياطي‬
23.) Shovel ‫شيول‬
24.) Flash Light ‫ليت‬
25.) Warning Triangles ‫مثلثات تحذير‬
26.) 2 Warning Cones ‫مخروط تحذير‬
27.) Water Jug ‫ترمس ماء‬
Cleanliness of Vehicle: ‫نظافة السياره‬
1.) Interior ‫النظافه الداخلية‬ Clean / Dirty Clean / Dirty
2.) Exterior ‫النظافه الخارجية‬ Clean / Dirty Clean / Dirty
Put Loss / Damage Reason (if
any):_____________________________________________________________________
NOTE: 1.) Employee who uses the company vehicle is responsible for maintenance or service, having accident report from Police in case of any
accident and inform timely the Admin Dept. in case of any loss or damage of vehicle.
2.) Employee is required to follow KSA driving rules and regulations and Applus-Velosi Road Transport policy (L1-POL-012).
3.) Don’t give the company vehicle to any other person /employee without the permission of Admin Department.
4.) Keep the interior and exterior clean. Company will deduct SR 50 for those users that are not maintaining the company vehicle clean .
5.) Company is not liable for any loss or damage of your personal belongings that you left inside the vehicle.
‫ ُمسَّلم السيارة‬Vehicle Handover By: - ‫ مستلم السيارة‬Vehicle Received By: - Data Recorded (In System) By:-

OUT Vehicle Name _________________ Name________________ Name____________________

‫خروج‬ Signature:______________ Signature: ____________ Signature: ________________

IN Vehicle Name _________________ Name________________ Name____________________

‫دخول‬ Signature: ______________ Signature: ____________ Signature: ________________