GARAGE REPAIR AND FUEL SERVICE AUTHORIZATION
FORM INSTRUCTIONS

1. For Office Use ONLY - This information is to be completed by the Office of Physical Plant
2. Enter the date the form is being completed
3. Select one of three authorization types:
• New - check this box if a new request and complete the new section below
• Change - check this box if this is a request to change an existing authorization and complete the change section below
• Delete - check this box if this request is to delete a vehicle and complete the delete section below
4. Enter the Department name
5. Enter the name of the individual responsible for the billing
6. Enter the phone number (including the area code) of the individual responsible for the billing
7. Enter the complete address of the individual responsible for the billing
8. Enter the name of the vehicle operator
9. Enter the supervisor's name of the vehicle operator

NEW INFORMATION SECTION:

10. If you have a preference, please enter the Equipment number you would like to use, one will be assigned when the form is received
11. Enter "NEW CARD" in the fuel card space if a fuel card is required for your NEW vehicle
12. Enter the license plate number from the vehicle
13. Enter the vehicle model year
14. Enter the Make and Model of your new vehicle. If you have the REGISTRATION CARD please include it with your completed form
15. Select the Cost Object type from the drop-down list:
    • Cost Center
    • Internal Order
    • Work Breakdown Structure
16. Enter the associated Cost Object number

CHANGE BUDGET INFORMATION SECTION: Please note that changes will not be effective until the 1st day of the next billing cycle

17. Enter the vehicle number requiring a budget change
18. If fuel card replacement is needed, please enter LOST or REPLACEMENT NEEDED in this space
19. Enter the license plate number from the vehicle requiring a budget change
20. Enter the vehicle model year
21. Enter the Make and Model of the vehicle requiring a budget change
22. Select the Cost Object type from the drop-down list that was originally charged
    • Cost Center
    • Internal Order
    • Work Breakdown Structure
23. Enter the Cost Object number originally charged
24. Select the Cost Object type from the drop-down list to be charged
    • Cost Center
    • Internal Order
    • Work Breakdown Structure
25. Enter the correct Cost Object number to be charged

DELETE VEHICLE SECTION:

26. Enter the vehicle number to be delete

APPROVALS SECTION:

27. Enter the name of the Budget Administrator or Budget Executive authorizing expenditures for this Garage and Fuel Service Order
28. Enter the date the Budget Administrator or Budget Executive completes the form
29. The Budget Administrator or Budget Executive provides either a hand-written signature or provides their digital ID
30. Enter the name of the Financial Officer verifying sufficient funds exist for these expenditures
31. Enter the date the Financial Officer verifies this information
32. The Financial Officer provides either their hand-written signature or provides their digital ID