VEHICLE MAINTENANCE REQUEST

DATE TIME VEHICLE #

Name of Person Completing Report

INSTRUCTIONS TO DRIVER: Describe problem/s below and submit to operation department office. If an emergency
exists, call +255 767241515 immediately. If not, call your immediately supervisor and give this form at your working
place.

INSTRUCTIONS TO SUPERVISOR: Beginning immediately all repair request must be submitted to the operation departments
office and the form must be signed by the supervisor or operation officer and submitted to the HRD for chain of approval .
Work CANNOT BEGIN without this completed form.

(DESCRIBE PROBLEM/S BELOW)

To be filled out by Supervisor

Please make the necessary repairs:

Immediately ASAP At next scheduled P.M. check

(emergency situation)

Supervisor’s Signature: Date:

HUMAN RESOURCE DEPARTMENTS AUTHORIZATION

Signature : Date……………………………….

MANAGING DIRECTOR OFFICE: FINAL APPROVAL

Signature : Date……………………………….