"State Vehicle Complaint Form" - Ohio

State Vehicle Complaint Form is a legal document that was released by the Ohio Department of Administrative Services - a government authority operating within Ohio.

Form Details:

  • Released on January 10, 2019;
  • The latest edition currently provided by the Ohio Department of Administrative Services;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Ohio Department of Administrative Services.

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Download "State Vehicle Complaint Form" - Ohio

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STATE VEHICLE COMPLAINT FORM
OHIO DEPARTMENT OF ADMINISTRATIVE SERVICES
General Services Administration
Office of Fleet Management
4200 Surface Road
Columbus, Ohio 43228-1395
Ph: (614) 466-6607
Matthew M. Damschroder,
Fax:(614) 752-8883
Mike DeWine,
Director
Governor
Section I.
License No:
# Occupants in Vehicle:
Description:
Seatbelts:
Color
Male or Female:
Date of Incident:
Comments:
Time of Incident:
Time of Day:
Section II.
Specific Location of Incident:
Description of Incident:
Additional Comments:
Please provide the Office of Fleet Management with a written response as to the action taken on this
issue.
Fleet Management Use Only
Agency Assigned
Date / Time Rec’d
Complaint Received By
NOTE: This Vehicle Complaint is being forwarded to the Fleet Manager of the agency holding title for the above listed state
vehicle. Please investigate the complaint and handle as you deem appropriate. If you have questions or require additional
information, please feel free to contact the Office of Fleet Management.
E-mail
E-mail
Pages:
To:
Address:
Rev. 1/10/2019
State Vehicle Complaint Form
STATE VEHICLE COMPLAINT FORM
OHIO DEPARTMENT OF ADMINISTRATIVE SERVICES
General Services Administration
Office of Fleet Management
4200 Surface Road
Columbus, Ohio 43228-1395
Ph: (614) 466-6607
Matthew M. Damschroder,
Fax:(614) 752-8883
Mike DeWine,
Director
Governor
Section I.
License No:
# Occupants in Vehicle:
Description:
Seatbelts:
Color
Male or Female:
Date of Incident:
Comments:
Time of Incident:
Time of Day:
Section II.
Specific Location of Incident:
Description of Incident:
Additional Comments:
Please provide the Office of Fleet Management with a written response as to the action taken on this
issue.
Fleet Management Use Only
Agency Assigned
Date / Time Rec’d
Complaint Received By
NOTE: This Vehicle Complaint is being forwarded to the Fleet Manager of the agency holding title for the above listed state
vehicle. Please investigate the complaint and handle as you deem appropriate. If you have questions or require additional
information, please feel free to contact the Office of Fleet Management.
E-mail
E-mail
Pages:
To:
Address:
Rev. 1/10/2019
State Vehicle Complaint Form