STAFF VEHICLE REQUEST FORM

PART A : General guidelines

o To expedite processing, please provide clear and complete information and tick ( / ) where appropriate.
o Request must be endorsed by Division Head of Requesting Department/Project before submission to
Administration Unit(PRPC)
o One month advanced notice is required for all request.
o A minimum of two (2) years contract is required for the usage of the on site vehicle.
PART B : To Be Filled by Requesting Personnel

1 NAME

2 POSITION

3 *H/P NO 019-220-7634

4 JOB GRADE REQUESTING FOR : SELF DEPT/DIVISION

5 DEPARTMENT/PROJECT

5 DIVISION
COST CENTRE

6 PROJECT LOCATION

7 *DURATION OF VEHICLE YY MM
REQUIRED * until completion of project - mandatory

8 WORK BASED :
(eg: PENGERANG)

9 STATUS PERMANENT EXECUTIVE

NON-PERMANENT NON-EXECUTIVE

10 TYPE OF VEHICLE REQUIRED SUV 4WD MPV

7 Seater 12 Seater 25 Seater

9 STATUS PERMANENT X EXECUTIVE

NON-PERMANENT NON-EXECUTIVE

12 REQUEST FOR DRIVER (S) Y/N

11 USING HOURS DAY

(eg : 6 days per week)
HOURS
(eg : 8.00 am to 6.00 pm)

13 WHEN REQUIRED DD MM YY
(1 mth advanced notice required)

SPECIAL VEHICLE
14
REQUIREMENT

FOR WORK AND SITE

15 PURPOSE

REQUESTED BY : ENDORSED BY :

NAME : ........................................................... NAME : ................................................

(PROJECT MANAGER/DEPARTMENT HEAD)

DECISION/ APPROVAL APPROVED DISAPPROVED

NAME ________________________________________________________
SIGNATURE DD MM YY

(PROJECT DIRECTOR of Sub Directorate)

ADMINISTRATION USE

APPLICATION RECEIVE DATE RECEIVE AND

PROCESSED BY
PROCESS DATE

VEHICLE DELIVERY DATE