Driver Gas Log
Name
*
First Name
Last Name
Which company car did you drive?
*
Car 1
Car 2
Car 3
Car 4
Car 6 (Need receipt for gas)
Van 1 (Need receipt for gas)
Van 2 (Need receipt for gas)
If your car is under 1/2 tank, you need to get gas.
Note: You need to get a receipt if you get gas in car 6 or a van. Cars 1 - 4 do not need receipts with the WEX Cards
Did you get Gas?
*
Yes
No
Take a picture of the Gas Guage
*
Take Picture of the receipt
*
Browse Files
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I have cleaned the trash out of my car.
*
Yes
No
Are there any maintenance issues that you need to report with this vehicle? Tell somebody if there is!
Camera issues, Cracked windshield, Tire issues, Dash Lights, etc.?
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Should be Empty: