USCA Form 13/20 (REVISED 7/96)
USCA VEHICLE RESERVATION REQUEST
TODAY’S DATE ______________________
REQUESTED BY _________________________________ DEPARTMENT _______________________
ACCOUNT TO CHARGE: DEPT # _____________ FUND # _____________ CLASS # _____________
TYPE OF VEHICLE: CAR VAN(15/PASS) TRUCK
DEPARTURE DATE __________ TIME __________ RETURN DATE __________ TIME __________
(Specify AM/PM, Noon/Midnight)
DESTINATION (CITY/STATE) _________________________________________________________
PURPOSE OF TRIP______________________________________________________________________
NAME OF DRIVER(S) _____________________________ # PASSENGERS ______________________
(Must have a valid MVR screening on file) (Do not include driver)
DRIVER’S STATUS: FACULTY STAFF STUDENT
(Student drivers must be accompanied by faculty or staff member when transporting other students [i.e. field trips, athletic events,
club outings, etc.]).
Do you wish to reserve a cellular phone? YES NO
NOTICE TO ALL USCA VEHICLE USERS
1. ALL vehicle reservation requests must be approved and on file in the Operations Office prior to actual travel
(2 weeks prior when possible).
2. Reservation times must be strictly adhered to as other trips re scheduled around times specified. Notify the
Operations Office immediately if you have a cancellation…we have more customers than vehicles.
3. All vehicles must be returned to the USCA compound after use and not parked at a residence oversight.
Return key packets, keys and credit cards to the Operations Office. Do NOT leave in vehicle. Use
emergency phone at front door of Supply & Maintenance Center to call security for assistance at times other
than normal working hours.
4. All drivers must submit a MVR Screening and cover sheet prior to use of a vehicle…NO EXCEPTIONS!
5. The diver assumes responsibility for return of vehicle in good condition. Water, oil and battery should be
checked at gas refills. Vehicle should be cleaned of all debris, and personal belongings removed.
6. All purchases for vehicles should be made with the state credit card provided. Receipts should include price
per gallon, # of gallons, total cost, etc.
7. NO alcoholic beverages allowed in vehicles.
8. Posted speed limits must be adhered to all times.
9. Seat belts must be worn at all times.
10. Headlights must be used in accordance with state laws.
11. NO SMOKING in vehicles.
12. Back vehicle with care. Use a flagman or circle vehicle prior to backing. (For more details, reference
University policy LESA 4.07.)
______________________________________
(Signature denotes travel approval)
