Vehicle Change Form

Vehicle Change Form

Manager Use Only
Is this for a brand new vehicle?
Please Use Vehicle Induction Form
Updated Driver Name:

First NameLast Name
New Vehicle Unit No.
Vehicle Tech Is Now Being Assigned
Driver's Former Unit No. (if applicable)
Vehicle Tech Was Formerly Assigned (if this is not driver's first vehicle assignment)
Home Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Registration Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Driver Email
example@culliganquench.com
Phone Number:

Area CodePhone Number
Gas Card Needed:
Gas Card PIN Needed:
GeoTab Device Needed:
Is this vehicle change due to a personnel change?
Name of Employee Removed from Vehicle:
Which needs to be updated?
If you are in need of a new GeoTab GPS device, please inform the Fleet Administrator, fleet@quenchwater.com

Do NOT remove the GeoTab device from the vehicle (unless we are selling this vehcile).
GeoTab Changes:
GeoTab Serial # for new vehicle
EZ Pass changes:
Enter EZ Pass transponder #
Mileage on New Vehicle:
Enter current mileage
New vehicle Plate#
Is this vehicle replacing another vehicle:
Which vehicle unit is being replaced?
Please enter Vehicle unit#
More information on old vehicle:
Manager Email Address:
jmanager@culliganquench.com
Please submit a change form for any vehicles affected by this change. i.e. status of old vehicle changing to "Open", old vehicle assigned to another tech, etc.
Should be Empty: