"Request for Blocked Vehicle From Ddds" - Delaware

This Delaware-specific "Request for Blocked Vehicle From Ddds" is a document released by the Delaware Office of Management and Budget.

Download the fillable PDF by clicking the link below and use it according to the applicable legal guidelines.

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Download "Request for Blocked Vehicle From Ddds" - Delaware

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STATE OF DELAWARE
OFFICE OF MANAGEMENT AND BUDGET
OFFICE OF FLEET SERVICES
REQUEST FOR BLOCKED VEHICLE FROM DDDS
AGENCY NAME/ADDRESS:
DDDS COMMUNITY SERVICES FLEET AUTHORIZATION:
DDDS OPERATIONS
PROVIDER/RESIDENTIAL PROGRAM
PROVIDER/DAY PROGRAM
GROUP HOME CONTACT:
REQUESTED VEHICLE TYPE:
BUSINESS EMAIL:
SITE LOCATION/ADDRESS:
CONTACT PHONE NUMBER:
REQUESTED START DATE:
Cost justify the need for requesting a vehicle larger than a mid-size sedan or requesting a specialized vehicle:
Signature of Authorized Community Services Manager
(Print Name)
Date
*Signature required only for vehicles larger than mid-size sedan
OBCBS CONTACT:
D/D/S (BILLING) CODE
BUSINESS EMAIL:
CONTACT PHONE NUMBER:
Signature of Authorized OBCBS Manager
(Print Name)
Date
DATE SENT TO OMB/FLEET:
ATTACHED IS ASSIGNMENT/ACKNOWLEDGEMENT
STATE OF DELAWARE
OFFICE OF MANAGEMENT AND BUDGET
OFFICE OF FLEET SERVICES
REQUEST FOR BLOCKED VEHICLE FROM DDDS
AGENCY NAME/ADDRESS:
DDDS COMMUNITY SERVICES FLEET AUTHORIZATION:
DDDS OPERATIONS
PROVIDER/RESIDENTIAL PROGRAM
PROVIDER/DAY PROGRAM
GROUP HOME CONTACT:
REQUESTED VEHICLE TYPE:
BUSINESS EMAIL:
SITE LOCATION/ADDRESS:
CONTACT PHONE NUMBER:
REQUESTED START DATE:
Cost justify the need for requesting a vehicle larger than a mid-size sedan or requesting a specialized vehicle:
Signature of Authorized Community Services Manager
(Print Name)
Date
*Signature required only for vehicles larger than mid-size sedan
OBCBS CONTACT:
D/D/S (BILLING) CODE
BUSINESS EMAIL:
CONTACT PHONE NUMBER:
Signature of Authorized OBCBS Manager
(Print Name)
Date
DATE SENT TO OMB/FLEET:
ATTACHED IS ASSIGNMENT/ACKNOWLEDGEMENT
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