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2) On Line Trip Authority 2022 DE AAR-KURUMAN

The document is a Trip Authorisation Form for the use of government-owned vehicles, requiring completion in full prior to departure. It includes details about the main driver, co-driver, trip itinerary, passengers, and vehicle inspection. The form also outlines conditions for vehicle use and responsibilities of the driver and transport officer.

Uploaded by

Tumi Shangwina
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58 views2 pages

2) On Line Trip Authority 2022 DE AAR-KURUMAN

The document is a Trip Authorisation Form for the use of government-owned vehicles, requiring completion in full prior to departure. It includes details about the main driver, co-driver, trip itinerary, passengers, and vehicle inspection. The form also outlines conditions for vehicle use and responsibilities of the driver and transport officer.

Uploaded by

Tumi Shangwina
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Trip Number -

81/147909 (Z606)
TRIP AUTHORISATION FORM FOR THE USE OF GOVERNMENT OWNED AND
SUBSIDISED VEHICLES
IMPORTANT NOTICE: THIS TRIP AUTHORITY IS SUBJECT TO THE CONDITIONS AS STIPULATED OVERLEAF
NB: This form has to be completed in full and in duplicate prior to departure, copy to be attached to official
Transport Request form in respect of general hire vehicle.

(TO BE COMPLETED BY THE PERSON REQUESTING


Name of main driver: Driver`s ID Number: Licence No: Code:
Michael Molusi 8311025801088 106400039YMD C1
Department: Section Telephone No:
SPORT, ARTS AND CULTURE EPWP & DISTRICT MANAGEMENT
Name of co-driver: Co-driver`s ID No: License No: Code:
Patrick Motsoatsoa 6212185629081 106400038NSV EB
Vehicle Registration No: Vehicle Station: Make/ Model

PART 1: TO BE COMPLETED BEFORE JOURNEY


Date Starting Point Odometer reading End Point Odometer reading Reason for trip

18/06/2023 MJE DE AAR Verification & Site visits


23/06/2023 KURUMAN KIMBERLEY Verification & Site visits

18/06/2023
Validity Period: Date From ………………………. 23/06/2023
To …………………….. 07:30
Time Period:From ………....… 22:00
To ………….…
Passengers: Enter names and ID No's of authorised passengers below. An ID MUST BE carried while travelling in a Government
Vehicle. Note: Hospital patients are exemted from carring ID, but names must be listed below

Name ID No. Reasons Name ID No. Reasons


Eugene Sebolai 7907025395087 Malebo Baboile
Verification & Site visits 9412220079089 Verification & Site visits
Mapaseka Motebe 9004150335084 Verification & Site visits

Goods / Equipment Quantity Reason

* If this is a permanent allocation of the vehicle, then provide a brief explanation of the intended use:

________________________________________________________________________________________________
18/06/2023 23/06/2023
From: _________________________________ To: _________________________________
ABOVE TRIPS AUTHORISED BY:
I hereby certify that the journeys are official and that funds are available to cover the expenditure.
Responsible Manager: Signature: Tel No: Date:

_________________________ ____________________ ___________________ _____________________

Supervisor`s Name: Signature: Tel No: Date:

_________________________ ____________________ ___________________ _____________________


RESP. CODE OBJECTIVE CODE

Transport Officer`s Name: Signature: Tel No: Date:

_________________________ ____________________ ___________________ _____________________


PETROL CARD NO.: (TO BE COMPLETED BY TRANSPORT OFFICER)

Issues by: _________________ Rank: _______________ Received By: ______________ Signature: ______________
VEHICLE INSPECTION AND ISSUE: Is the vehicle roadworthy YES NO

Indicate defects on vehicle prior to departure with ______________________________________________________

I hereby confirm that I hold a valid driver's licence and acknowledge that I have read and understood my
responsibilities as the driver of this official vehicle set out in the Handbook for Drivers of Official Vehicles.

Driver`s Signature: ____________________________ Date: ____________________________

PART 2: TO BE COMPLETED AFTER THE JOURNEY


Number of fuel vouchers issued to the driver before the trip,
and the number of used vouchers returned after the completion of the trip

Indicate defects on vehicle on completion of trip _______________________________________________________

Refueling particulars (Slips to be attached)

Litres Value Quantity of Fuel


KM/ Replenished (Subsequent to journey)
Date Name of Town (Tick relevant column)
Reading Service Station Fuel Oil R C F 3/4 1/2 E

Vehicle and Petrol Card returned by:


Driver`s Name: Driver`s Signature: Date:
Michael Molusi
_________________________ ____________________________ _____________________

Transport Officer`s Name: Transport Officer`s Signature: Date:

_________________________ ____________________________ _____________________

The trip authority will be subject to the following conditions:


● The contents of the Transport and the Driver's of Official Vehicles Handbooks are
understood and adhered to at all times.
● That the vehicle may not be re-fuelled unnecessarily.
● That authority is obtained to keep the vehicle overnight.
● That the Transport Section be advised as soon as possible of trip cancellation.
● Vehicle keys are only issued to authorised licensed driver. Department Stamp
● That the Fleet Management Service Provider card and keys are handed back to the
Transport Officer as soon as possible after the journey.
● Vehicle is issued with the following tools/accessories: Triangle(s), jack, wheel spanner,
spare wheel(s), petrol cap, petrol card no.

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