SELF DRIVE CAR RESERVATION FORM

Requested by:________________________________________ Date Issued:__________________

Driver Name

Department:_____________________________________ _____ Car/Unit _______________

Purpose:______________________________________________________________________________
_____________________________________________________________________________________

The following persons are permitted to ride the requested vehicle from ______________ (AM/PM) to
______________ (AM/PM), on _____________________:
DATE

1. ___________________________________
2. ___________________________________
3. ___________________________________
4. ___________________________________

Employee/Applicant hereby swear to accept and assume full responsibility for any loss or damage to
properties on the vehicle requested and shall compensate the property owner for such loss or damages if
upon appropriate investigation, it is established that loss or damage is due to sole fault and negligence of
Contractor/Applicant.

EMPLOYEE CONFORME: __________________________________________________________

Name & Signature of Authorized Representative
NOTED BY: __________________________________________________________
Department Head Authorized Signatories
NOTED BY: __________________________________________________________
HR Department

APPROVED BY: __________________________________________________________

Building Management

IMPORTANT NOTICE TO CONTRACTOR/TENANT: Please comply with the Building Admin’s rules and regulations
in accordance with the Specific obligations and behavior’s expected from drivers; Company car usage eligibility criteria;
Accidents guidelines; and our Company’s obligations.