Vehicle Requisition - Arkansas State University Mountain Home

ASUMH Motor Vehicle Requisition

(Vehicle to be picked up and returned to the Maintenance Building)

Issue Vehicle to:
Additional driver/drivers:
Arkansas Driver Lic No.:
Date wanted:
Time wanted:
Type (van, car, truck)
Number passengers:
Date to be returned:
Time to be returned:
Official business to be performed:
Destination:
Department:
Phone Number:
Email:
Account no. to be charged:
Date Submitted:
Email of Chancellor or apropriate Vice Chancellor

* Routing of this form: To appropriate vice chancellor, to travel administrator, to director of physical plant. See below for list.

Department	Chancellor or Vice Chancellor
Chancellor's Office	Chancellor
Instruction, Student Services, Registrar's Office, Library, Continuing Education	Vice Chancellor for Academic Affairs
Financial Aid, Maintenance, Security, Administrative Affairs, Adult Education, Computer Services	Vice Chancellor for Administrative Affairs
Development, Public Relations/Marketing	Vice Chancellor for Development

1600 South College St. • Mountain Home, AR 72653 • Telephone: (870) 508-6100 • Fax: (870) 508-6287 Security