Form OFMFRM0004 "Das Fleet Refund/Pass-Through Request" - Ohio

What Is Form OFMFRM0004?

This is a legal form that was released by the Ohio Department of Administrative Services - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on January 1, 2019;
  • The latest edition provided by the Ohio Department of Administrative Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form OFMFRM0004 by clicking the link below or browse more documents and templates provided by the Ohio Department of Administrative Services.

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Download Form OFMFRM0004 "Das Fleet Refund/Pass-Through Request" - Ohio

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DAS Fleet Refund Request 
INSTRUCTIONS 
The  following  procedure  is  for  reimbursement  of  a  fleet  expense  (Fuel  or  Maintenance)  to  a  state 
employee using a DAS managed vehicle, should the State Fleet Card not work.  The state employee would 
not use the standard Travel and Expense reimbursement process through the OAKS FIN; instead, follows 
the DAS Fleet Refund Request process below: 
1. The state employee must be registered in OAKS as a supplier. If the state employee is uncertain
if they are already a supplier in OAKS, they must contact the OSS Help Desk 1.877.644.6771.
2. If the state employee is not a supplier in OAKS, they must contact their agency's Human
Resources Office. The agency's Human Resources Office must FAX the following HCM screen
shots to Ohio Shared Services at 1.614.485.1039 or email SUPPLIER@OHIO.GOV.
VIEW NAME
o
CONTACT INFORMATION SCREEN
o
BIOGRAPHICAL DETAILS SCREEN SHOWING SOCIAL SECURITY NUMBER
o
3. Once a state employee has an OAKS Supplier ID, the state employee needs to fill out the DAS
Fleet Refund Request Form provided by DAS/Office of Fleet Management. The completed form
and a copy of the receipt must be submitted to DASFLEET@DAS.OHIO.GOV.
4. DAS/Office of Fleet Management will process the reimbursement via Ohio Shared Services.
If assistance is required with this process, please contact DAS/Office of Fleet Management at:
Phone: 1.614.466.6607
o
Toll Free: 1.800.686.1521
o
DASFLEET@DAS.OHIO.GOV 
O
The State of Ohio is an equal opportunity employer.
   
Mike DeWine, Governor
Office of Fleet Management | 4200 Surface Road | Columbus, Ohio 43228
Matthew M. Damschroder, Director
 
Phone: 614-466-6607 | Email DASFleet@das.ohio.gov
das.ohio.gov
William R. Simon, State Fleet Administrator
 
DAS Fleet Refund Request 
INSTRUCTIONS 
The  following  procedure  is  for  reimbursement  of  a  fleet  expense  (Fuel  or  Maintenance)  to  a  state 
employee using a DAS managed vehicle, should the State Fleet Card not work.  The state employee would 
not use the standard Travel and Expense reimbursement process through the OAKS FIN; instead, follows 
the DAS Fleet Refund Request process below: 
1. The state employee must be registered in OAKS as a supplier. If the state employee is uncertain
if they are already a supplier in OAKS, they must contact the OSS Help Desk 1.877.644.6771.
2. If the state employee is not a supplier in OAKS, they must contact their agency's Human
Resources Office. The agency's Human Resources Office must FAX the following HCM screen
shots to Ohio Shared Services at 1.614.485.1039 or email SUPPLIER@OHIO.GOV.
VIEW NAME
o
CONTACT INFORMATION SCREEN
o
BIOGRAPHICAL DETAILS SCREEN SHOWING SOCIAL SECURITY NUMBER
o
3. Once a state employee has an OAKS Supplier ID, the state employee needs to fill out the DAS
Fleet Refund Request Form provided by DAS/Office of Fleet Management. The completed form
and a copy of the receipt must be submitted to DASFLEET@DAS.OHIO.GOV.
4. DAS/Office of Fleet Management will process the reimbursement via Ohio Shared Services.
If assistance is required with this process, please contact DAS/Office of Fleet Management at:
Phone: 1.614.466.6607
o
Toll Free: 1.800.686.1521
o
DASFLEET@DAS.OHIO.GOV 
O
The State of Ohio is an equal opportunity employer.
   
Mike DeWine, Governor
Office of Fleet Management | 4200 Surface Road | Columbus, Ohio 43228
Matthew M. Damschroder, Director
 
Phone: 614-466-6607 | Email DASFleet@das.ohio.gov
das.ohio.gov
William R. Simon, State Fleet Administrator
 
Agency
Payment
Request
DAS Fleet Refund/Pass‐Through Request 
*
Bill to Agency: DAS01
Employee Agency Name & Business Unit :
Division:
Bargaining Unit:
Date:
Last Receipt Date:
Refund Amount:
Name of Employee Purchasing Goods:
Employees OAKS Supplier ID #:
*
Invoice No:
*
(This is not the same as an Employee ID#)
Address Number and Street
City
State
Zip
Unit Number/Reason for Using Personal Funds: 
Supervisor’s Signature:
Title:
Date:
Enter Speed Chart Name or Chartfield String
(Completed by DAS Fleet)
Speed Chart
Fund
Account Code
ALI
Department
Program
560059
1220
100637
DAS105925
Grant/Prj
Project
Serv Loc.
Reporting
Agency Use
Budget Ref.
Rev 01/19
OFMFRM0004
The State of Ohio is an equal opportunity employer.
   
Mike DeWine, Governor
Office of Fleet Management | 4200 Surface Road | Columbus, Ohio 43228
Matthew M. Damschroder, Director
 
Phone: 614-466-6607 | Email DASFleet@das.ohio.gov
das.ohio.gov
William R. Simon, State Fleet Administrator
 
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