Form MFOMS-18 "Certification of Exemption - State Motor Vehicle Commute Charge" - Maryland

What Is Form MFOMS-18?

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

Form Details:

  • Released on January 1, 2020;
  • The latest edition provided by the Maryland Department of Budget and Management;
  • 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 MFOMS-18 by clicking the link below or browse more documents and templates provided by the Maryland Department of Budget and Management.

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Download Form MFOMS-18 "Certification of Exemption - State Motor Vehicle Commute Charge" - Maryland

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MFOMS-18
CERTIFICATION OF EXEMPTION
STATE MOTOR VEHICLE COMMUTE CHARGE
(Revised 1/2020)
Agency Name:
Agency Appropriation Code: (found on your paystub)
State Vehicle License Plate #:
State Vehicle VIN#:
State Vehicle Type (Sedan, Van, Pickup, SUV, etc…):
Assigned Driver:
_____________________________________________________________________________________________________
Last name
First name
Middle initial
Assigned Driver’s Title and Office/Unit Name:
Briefly Describe the duties & responsibilities of this position:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Driver’s Home Address:
Street
Unit/Apt. #
City
State
Zip Code
Driver’s State Office Address:
Street
Room/Suite #
City
State
Zip Code
Address at which the vehicle will be parked overnight:
Street
Unit/Apt. #
City
State
Zip Code
Exemption Requested: - Please check accordingly
1_____ 2_____ 3_____ 4_____
Note that only one exemption may be requested
EXEMPTION 1: Assigned vehicle is not used to commute but remains parked overnight at the authorized
driver’s assigned office. Vehicles that are driven from the driver’s assigned office to a regional office, branch or
any other sub-unit of the State and parked overnight do not qualify under this exemption.
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MFOMS-18
CERTIFICATION OF EXEMPTION
STATE MOTOR VEHICLE COMMUTE CHARGE
(Revised 1/2020)
Agency Name:
Agency Appropriation Code: (found on your paystub)
State Vehicle License Plate #:
State Vehicle VIN#:
State Vehicle Type (Sedan, Van, Pickup, SUV, etc…):
Assigned Driver:
_____________________________________________________________________________________________________
Last name
First name
Middle initial
Assigned Driver’s Title and Office/Unit Name:
Briefly Describe the duties & responsibilities of this position:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
Driver’s Home Address:
Street
Unit/Apt. #
City
State
Zip Code
Driver’s State Office Address:
Street
Room/Suite #
City
State
Zip Code
Address at which the vehicle will be parked overnight:
Street
Unit/Apt. #
City
State
Zip Code
Exemption Requested: - Please check accordingly
1_____ 2_____ 3_____ 4_____
Note that only one exemption may be requested
EXEMPTION 1: Assigned vehicle is not used to commute but remains parked overnight at the authorized
driver’s assigned office. Vehicles that are driven from the driver’s assigned office to a regional office, branch or
any other sub-unit of the State and parked overnight do not qualify under this exemption.
Page 1 of 2
EXEMPTION 2: Vehicle is assigned to an authorized driver whose duties are primarily field assignments and
who reports to the designated office an average of once a week or less, as certified by the Agency Head.
These drivers are generally not required to report to an assigned location at the beginning or end of their
workday. Once per week or more responses to a regional office, branch or any other sub-unit in lieu
of responding to the driver’s headquarters disqualifies the driver from this exemption.
List normal office visit schedule for authorized driver in accordance with policy, and as shown on their mileage
log for the previous 12 months:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
EXEMPTION 3: Vehicle is assigned to a Law Enforcement Officer
EXEMPTION 4: Vehicle is modified and equipped with highly specialized equipment necessary to respond to
emergency needs and the assigned driver is subject to emergency call out at times other than scheduled
working hours. Examples of vehicle types are: bomb disposal trucks, haz-mat response trucks, and traffic
signal repair trucks. Vehicles must be specifically designed and used to carry and store highly specialized
emergency equipment. Two-way radios, emergency lights, and other ancillary equipment do not qualify.
List vehicle type, modifications, and specialized equipment:
________________________________________________________________________________
________________________________________________________________________________
________________________________________________________________________________
The undersigned certify the above statements are accurate and agree to make proper notification to the Department
of Budget and Management in the event that a change in assignment or job duties occurs which nullifies the accuracy
of this certification. If there is a change in the driver’s job functions, assignment, home address or address
where the vehicle will be parked overnight, a new MFOMS-18 must be submitted for approval.
ASSIGNED DRIVER SIGNATURE
PRINT NAME
DATE
FLEET MANAGER’S AUTHORIZATION
PRINT NAME
DATE
DEPARTMENT/AGENCY HEAD AUTHORIZATION
PRINT NAME
DATE
DEPARTMENT OF BUDGET & MANAGEMENT APPROVAL
DATE
The assigned driver and State vehicle listed above are certified as exempt from State
vehicle commute charges resulting from the information provided.
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