Vehicle Rental Form
General Note: Section 1525.F, State Travel Regulation provides for the use of rental vehicles while traveling on State
Business. However, to qualify for a rental vehicle it must be the only form of transportation available for the most economical
means by which the purpose of the trip can be accomplished. This request must be approved by the VICE PRESIDENT OF
ADMINISTRATION & FINANCE through the appropriate VICE PRESIDENT for the budget unit affected.
On-Line Travel Authorization No.
Date(s) of Travel
Name of Driver
Driver’s W#
The Office of Risk Management, State of Louisiana, carries a Liability Collision and
Comprehensive insurance on all vehicles the Uni
versity rents. Prior to
taking possession of a rented
vehicle as a University employee, I will inspect the vehicle for any prior damage such as:
1. Scratches and dents on body of vehicle
2. Pecks, scratches, cracks on thewindshield
3. Torn upholstery, etc.
Any damages noticed must be noted on the Lease Agreement. The same process should be
completed with the leasing agent when the vehicle is returned.
The above practice will reduce the amount the state is being charged for damages, which we may not
owe. Any accident involving a rental vehicle must be reported in the same manner as any vehicle
used on University time.
Signature of Driver
Date of Request
Budget Unit Head
/ Date
Dean/AVP (if applicable)
/ Date
Provost/Vice President
/ Date
Vice President of
/ Date
Administration & Finance
Revised 11/29/2018
Purpose of trip:
Documentation of Cost Effectiveness/only method of transportation:
Driver’s Email
*Provide justification below if class is larger than standard size.
If 15 Passenger Van (per University Policy):
Vehicle class you will be renting-
· Driver has class D license:
· Van is a TRANSIT van:
Yes No
Yes No
(Must complete form online)