University Fleet Authorized Driver Addendum Form

Driver Information

Full Name

University ID Number

Department

Phone Number

Email Address Driver's License Number State of Issue License Expiration Date

Vehicle Type(s) to be Driven

Purpose of Use

Supervisor Name Supervisor Email Authorization/Notes

I hereby certify that the above information is accurate, and I agree to adhere to all University fleet vehicle policies and procedures.

Driver Signature Date

Supervisor Signature Date