Day Ten Upload completed trip ticket information here. Bus Captain / Chauffeur*CHOOSE ONE BELOW:1 New or Unlisted ChauffeurBarbosa, Carol - ID#3-CarolBarBarbosa, Sammy - ID#264-SammyBaumbach, Joseph – ID#484-JBaumbBeckett, Craig – ID#518-CraigBBrown, Tim – ID#429-TimBroCook, Mike – ID#503-MRCookDePremo, Margaret - ID#301-MDePreDierschow, Gerald - ID#342-GeralEthridge, Wesley – ID#495-WEthriFerreira, Andre- ID#4-AndreFauber, James - ID#123-JamesFFerguson, Barbara – ID#497-BFerguFerreira, Andre - ID#4-AndreFranklin, Chris – ID#525-CFrankHairston, Carl – ID#492-CHairsHall, Sheryl - ID#332-SherHaHamblen, Tom – ID#529-THamblHayes, Steve – ID#509-SHayesHickman, Jim – ID#266-JHickmHill, Nathan – ID#504-NaHillHouff, David- ID#512-DHouffJenkins, Luther - ID#458-LutheJJohnson, Brian - ID#479-BJohnsLeFon, David - ID#283-DLefonLeFon, Conni – ID#517-ConniLMassie, Jerry - ID#16-JerryMaMcGraw, Billy – ID#527-BillyMMcNeilus, Tom – ID#506-TMcNeiPatterson, Dennis - ID#209-DennisPrice, Richard – ID#526-RPriceShifflett, Shawna – ID#494-ShawnaShuff, Robert – ID#491-RShuffSlattery, Galen- ID#149-GalenSSmith, Stacey – ID#528-SSmithSmith, Tim – ID#000000Taylor, Stephen - ID#116-StepheThomas, Terrence – ID#522-TerrThThompson, Vaden- ID#523-VadenTWebb, Kim- ID#524-KAWebbWhite, Bill – ID#502-BHWhitWilliams, Isabella – ID#521-IsabeWWilson, Larry – ID#467-LWilsoWorley, Jamie – ID#499-JWorleYoung, Jackie – ID#488-JYoungIf you would like a copy of this ticket enter your email here Trip Number* Trip Number: Vehicle Number*CHOOSE ONE BELOW:1106 Van Ford1414 Van Ford1415 Van Ford2004 Minibus2103 Minibus2104 Minibus2418 Minibus2419 Minibus2420 Minibus2421 Minibus3205 Minibus3206 Minibus344 Sedan Lincoln5101 Bus Prevost5401 Bus Volvo5402 Bus Volvo5403 Bus MCI5603 Bus MCI5605 Bus MCI5607 Bus Volvo5608 Bus MCI5610 Bus MCI5611 Bus Volvo5614 Bus MCI5615 Bus MCI5616 Bus MCI5617 Bus MCI5618 Bus MCI5619 Bus MCI5804 Bus Prevost615 SUV GMC618 SUV ChevyRental VehicleStart Date* MM slash DD slash YYYY Terminal Start Time* : Hours Minutes AM PM AM/PM Departed Terminal : Hours Minutes AM PM AM/PM Onsite* : Hours Minutes AM PM AM/PM Passenger On Board* : Hours Minutes AM PM AM/PM Stop Details & NotesReleased* : Hours Minutes AM PM AM/PM Park Time at Location/Terminal : Hours Minutes AM PM AM/PM End Location/Terminal* : Hours Minutes AM PM AM/PM Fuel and Mileage Location* Virginia Miles/Fuel Only Virginia And/Or Other State Miles And/Or Fuel Beginning Odometer*End Odometer*Other State with MilesCHOOSE ONE IF NEEDED.VirginiaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontWashingtonWest VirginiaWisconsinWyomingMiles in That StatePlease enter a number from 1 to 999.Other State with MilesCHOOSE ONE IF NEEDED.VirginiaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontWashingtonWest VirginiaWisconsinWyomingMiles in That StatePlease enter a number from 1 to 999.Other State with MilesCHOOSE ONE IF NEEDED.VirginiaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontWashingtonWest VirginiaWisconsinWyomingMiles in That StatePlease enter a number from 1 to 999.Other State with MilesCHOOSE ONE IF NEEDED.VirginiaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontWashingtonWest VirginiaWisconsinWyomingMiles in That StatePlease enter a number from 1 to 999.Other State with MilesCHOOSE ONE IF NEEDED.VirginiaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontWashingtonWest VirginiaWisconsinWyomingMiles in That StatePlease enter a number from 1 to 999.Other State with MilesCHOOSE ONE IF NEEDED.VirginiaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontWashingtonWest VirginiaWisconsinWyomingMiles in That StatePlease enter a number from 1 to 999.Virginia MilesState of Fuel Purchase #1VirginiaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontWashingtonWest VirginiaWisconsinWyomingPaid By Company Paid Personally Paid Gallons to 3 digitsFuel Cost (if known)State of Fuel Purchase #2VirginiaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontWashingtonWest VirginiaWisconsinWyomingPaid By Company Paid Personally Paid Gallons to 3 digitsFuel Cost (if known)State of Fuel Purchase #3CHOOSE ONE IF NEEDED.VirginiaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontWashingtonWest VirginiaWisconsinWyomingPaid By Company Paid Personally Paid Gallons to 3 digitsFuel Cost (if known)Total GallonsTotal Fuel CostTotal Miles Per OdometerTotal Miles By Adding States (Must Match)Non-Fuel Expenses Zero Non-Fuel Expenses On This Trip Some Non-Fuel Expenses On This Trip Expense Type #1CHOOSE BELOWAccess FeeClient Amenity (Note in Description)Dump CommodeFuel Not Paid by Company (Note Gallons in Description)Hotel StayOil/Antifreeze/FluidsParking ChargeToll FeeVehicle WashWater/IceOther (Note in Description)Paid By Company Paid Personally Paid Expense Amount #1Expense Description #1Expense Type #2CHOOSE BELOWAccess FeeClient Amenity (Note in Description)Dump CommodeFuel Not Paid by Company (Note Gallons in Description)Hotel StayOil/Antifreeze/FluidsParking ChargeToll FeeVehicle WashWater/IceOther (Note in Description)Paid By Company Paid Personally Paid Expense Amount #2Expense Description #2Expense Type #3CHOOSE BELOWAccess FeeClient Amenity (Note in Description)Dump CommodeFuel Not Paid by Company (Note Gallons in Description)Hotel StayOil/Antifreeze/FluidsParking ChargeToll FeeVehicle WashWater/IceOther (Note in Description)Paid By Company Paid Personally Paid Expense Amount #3Expense Description #3Additional Trip NotesImage Upload Drop files here or Select files Accepted file types: jpeg, jpg, gif, png, pdf, mov, Max. file size: 8 GB. Certification* Certified True With Concerns I certify that the information contained herein is true and correct.PhoneThis field is for validation purposes and should be left unchanged.
