Rental Form Fleet Services Daily Rental Authorization Form Time Stamp Driver Information Reservation Number First Name Last Name Phone Number Department Supervisor/Manager/Director Name Supervisor/Manager/Director Number Pick-Up Date Return Date Destination Authorized Account Number to be Charged (Campus) Please use allowable daily rental accounts 65600 – 65619 (Hospital) May only use account (02) 65690 Please enter a NA in the field that is not applicable to your account BU ORG FUND ACTIVITY PROJECT ACCOUNT AU Product Group Place Authorization This authorization form must be completed and returned to Fleet Services prior to release of vehicle Signature signature keyboard Clear This authorization form must be completed and returned to Fleet Services prior to release of vehicle Today's Date Submit Δ