Individual Vehicle Distance Fuel Report Form PDF Details

Are you a fleet manager looking for an efficient and effective way to track fuel usage? Do you need accurate, detailed information on vehicle mileage throughout the year? If so, then you need to look into implementing an individual vehicle distance fuel report form. This form provides managers with important data related to their vehicles' performance including miles per gallon (MPG), fuel costs associated with operating each vehicle, and other important figures that can help improve overall efficiency. With these metrics readily available in one easy-to-access location, managers can make better informed decisions about how they use their fleets moving forward.

QuestionAnswer
Form NameIndividual Vehicle Distance Fuel Report Form
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesmichigan individual vehicle, individual vehicle distance, mi fuel report, distance fuel report

Form Preview Example

Individual Vehicle Distance and Fuel Record (IVDR)

Use this form to record distance and fuel used for a trip or day of activity for a single vehicle. These records should be kept for five (5) years. See page 2 for instructions to complete the form.

Carrier Name

Carrier and Vehicle Information

Carrier Address

City

State

Zip Code

 

 

 

 

Vehicle Unit Number

Vehicle Driver Name

Fuel Type

Trip Origin – State/Jurisdiction Lines –

Towns – Trip Destination

Odometer

Distance by State/Jurisdiction

and from Point to Point

Highway or

Route Traveled

Date Starting

and Ending

Name and Address of Fuel, Load/Delivery,

or Destination Stop

Gallons

Purchased

Ending Odometer

Beginning Odometer

Total Trip Distance

Total Trip Distance

Total Distance Per State/Jurisdiction

Total Fuel Purchased

Total Trip Distance

Instructions for Completing the Individual Vehicle Distance and Fuel Record

Please print all information entered on the IVDR. In case of an audit, it is very important for the information on this form to be legible.

1.Enter the Carrier’s name.

2.Enter the Carrier’s street address, city, state, and zip code.

Note: If you are leased on with a carrier based in Canada, enter the province name in the state field and the carrier’s postal code in the zip code field.

3.Enter the vehicle unit number also referred to as the truck number. This is not the same as a Vehicle Identification Number (VIN).

4.Enter the driver’s name who is completing the trip recorded on this form.

5.Enter the fuel type used in the vehicle, i.e., diesel, propane, gas, etc.

6.In the Trip Origin – State/Jurisdiction Lines – Towns – Trip Destination column, enter the following:

a.Trip Origin – the city and state/jurisdiction where the trip begins

b.State/Jurisdiction Lines – each state or jurisdiction line crossed

c.Towns where you load or unload

d.Trip Destination – the city and state/jurisdiction where the trip ends

7.In the Odometer column, enter the odometer reading which corresponds to each of the locations entered in #6 above.

8.In the Distance by State/Jurisdiction and from Point to Point column, enter the mileage between each of the locations entered in #6 above.

9.In the Highway or Route Traveled column, enter the road, highway or interstate traveled between each of the locations entered in #6 above.

10.In the Date Starting and Ending column, enter the date the trip began, the date you were in each location between the origin and destination locations, and the date the trip ended.

11.In the Name and Address of Fuel/Load and Delivery, or Destination column, enter the street address, city, state/jurisdiction, and zip or postal code for each location entered in #6 above.

12.In the Gallons Purchased column, enter the total number of gallons of fuel purchased at each fuel stop.

13.In the bottom section of the form, enter the Ending Odometer reading and the Beginning Odometer reading. The Total Trip Distance is the difference between these two readings.

14.The second field named Total Trip Distance is the total of all miles entered in the Odometer column. The number in this field should equal the total trip distance determined in #13 above.

15.In the Total Distance by State/Jurisdiction section, add the miles listed for each state or jurisdiction in #8 above and enter the total for each state.

16.In the Total Fuel Purchased field, enter the total number of gallons purchased during the trip. This is determined by adding the number of gallons purchased at each stop and listed in #12 above.

17.In the last Total Trip Distance field, add all miles for each state/jurisdiction (listed in #15) and enter the total. This total should match #13 and #14 above.

USE THIS FILLED OUT FORM AS A GUIDE - RESPONSES WILL VARY

Carrier and Vehicle Information

Carrier Name

Carrier Address

City

State

Zip Code

 

 

IRP Trucking Co.

7064 Crowner Dr

 

 

Dimondale

MI

 

 

48821

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Vehicle Unit Number

Vehicle Driver Name

 

 

Fuel Type

 

 

 

 

 

 

 

 

 

101

John Smith

 

 

Diesel

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Trip Origin – State/Jurisdiction Lines –

Odometer

 

Distance by State/Jurisdiction

Highway or

Date Starting

Name and Address of Fuel, Load/Delivery,

 

Gallons

 

 

 

Towns – Trip Destination

 

and from Point to Point

Route Traveled

and Ending

or Destination Stop

 

 

 

 

Purchased

 

 

 

 

 

 

 

 

 

 

 

Start – Dimondale, MI

45,678

 

 

 

 

7/1/20

7064 Crowner Dr., Dimondale, MI -

 

 

 

 

 

 

 

 

 

 

 

 

 

Home

 

 

 

 

 

 

 

Ohio State Line

45798

120 MI

96, 23

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Toledo, OH

45810

12 OH

 

 

 

Fuel - Speedway, Toledo, OH

 

 

100

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Canton, OH

45969

159 OH

80/90, 77

 

 

Rest Stop

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Kentucky State Line

46314

345 OH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Louisville, KY

46334

20 KY

70, 71

 

 

Delivery - 1234 Louie Road,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Louisville, KY

 

 

 

 

 

 

 

Ohio State Line

46354

20 KY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cincinnati, OH

46454

100 OH

71

 

 

Delivery – 345 Blue Rd., Canton,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OH

 

 

 

 

 

 

 

Michigan State Line

46654

200 OH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

End - Dimondale, MI

46776

122 MI

75, 96

7/2/20

7064 Crowner Dr.,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Dimondale, MI - Home

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Ending Odometer

 

 

 

 

Total Distance Per State/Jurisdiction

 

 

Total Fuel Purchased

 

 

 

 

46776

 

 

 

MI

 

242

 

 

 

 

100 Gal

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OH

 

816

 

 

 

 

 

 

 

 

Beginning Odometer

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

45,678

 

 

 

KY

 

40

 

 

 

 

Total Trip Distance

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1098

 

 

 

 

 

Total Trip Distance

 

Total Trip Distance

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

1098

1098

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Completing section 1 in individual vehicle distance

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