| CURRENT VEHICLE DETAILS (all boxes must be completed) | |
| Registration Number |
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| Make (eg Holden, Ford, Mitsubishi, Toyota) |
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| Model (eg Acclaim, Futura, Magna, Corolla) |
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| Body Style (eg Sedan,Wagon,Hatch,Utility, 4WD) |
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| Current klms |
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| 20,000 klms expected by |
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| ADDITIONAL/REPLACEMENT VEHICLE DETAILS | |||||
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Make
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Holden
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Ford
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Mitsubishi
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Toyota
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Other Makes |
| Model | Acclaim | Futura | Magna | Corolla | Other Models |
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Body Style
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Fuel
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Transmission
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Engine Capacity Litre
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| ACCESSORIES | ||||
| Air Conditioning | Power Steering | Power Windows | Mud Flaps (F&R) | |
| H/light Protectors | Driver Airbag | Passenger Airbag | CD Player stack | |
| Driver W/shield | Pass. W/shield | Towbar/Ball/Wiring | Transfer Phone | |
| Other Options |
Colour Preference
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| CONTACT DETAILS | |
| Faculty/School/Division | |
| Faculty/School/Division Contact Person | |
| Contact Phone Number | |
| Conditions: | ||
1. Vehicle must be approaching 12 months old or 20,000kms. Actual changeover cannot occur prior to 12 months or 20,000 kms. |
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| AUTHORISATION | ||
| Authorised By Pro Vice Chancellor/Head of Division: _______________________________________________ | ||
| Signature: __________________________________Date:________________ Account to which any Profit/(Loss) on disposal of vehicle is to be credited/(charged) - - |
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| SUPPLY AND PAYMENTS USE ONLY: | |
| Vehicle Changeover Cost Centre | - - 6705 |
| Rego/CTP/Fleetcard Cost Centre | - - 6301 |
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For guidelines for an additional vehicle and further information regarding purchase of vehicles refer to the Motor Vehicle Policy
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