Fillable Printable Driver Trip Report Template
Fillable Printable Driver Trip Report Template
Driver Trip Report Template
(Driver Trip Report)
TRACTOR NO
HUBOMETER READING
DRIVER
TRAILER NO. ENDING: ORIGIN
TRAILER NO. BEGINNING: DESTINATION
TOTAL HUB MILES: DESTINATION
LOCATION CARRIER (LESSEE)
TRAILER AXLES: TRIP LEASE #
DIESEL GAS L.P.G. 1 2 3 4 CARGO WT. (COLO.)
DRIVER MUST ENTER ODOMETER READING
BEGINNING AND BY STATE EXIT
(DRIVER TO COMPLETE ALL AREAS BEGINNING ODOMETER READING DRIVER TO ENTER MILEAGE & FUEL PURCHASES FOR FUEL
SEE INSTRUCTIONS & SAMPLE ON BACK) MILEAGE AND HIGHWAY TAX REPORTING
LINE
NO. DATE
STATE OR
PROVINCE
HIGHWAYS
USED
ODOMETER READING
STATE EXIT NON-TOLL
TOLL
L=LOADED
E=EMPTY
TRIP
PERMIT
TRIP
CITIES
FUEL
GALS. PURCHACES VENDOR
INVOICE
NUMBER
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
ENDING ODOMETER READING
DATE
TRIP REPORT NUMBER
STATE LAWS REQUIRE THE DRIVER TO
KEEP A RECORD OF MILES DRIVEN AND
FUEL PURCHASED IN EACH STATE FOR
EACH TRIP.
DRIVER/CONTRACTOR'S SIGNATURE
