Form FM-12e "Travel Log for Permanently Assigned Vehicles" - North Carolina

What Is Form FM-12e?

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

Form Details:

  • The latest edition provided by the North Carolina Department of Administration;
  • 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 FM-12e by clicking the link below or browse more documents and templates provided by the North Carolina Department of Administration.

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Download Form FM-12e "Travel Log for Permanently Assigned Vehicles" - North Carolina

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Total Miles
FM-12e
STATE OF NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION
Rate per Mile
Motor Fleet Management Division, Raleigh
Mileage Charge
TRAVEL LOG
Monthly Fee
$35.00
FOR PERMANENTLY ASSIGNED VEHICLES
Total Amount
Department
Agency
Dept./Off. No.
Fund No.
RCC No.
Vehicle No.
Individual Responsible for Vehicle:
Approval of Agency Head or Supervisor:
For Month Of
TRIP DATES
OFFICIAL TRAVEL
MILEAGE
From
To
Purpose of Trip
Signature
Out
In
Miles
Leave Return
Odometer
No. of
No. of Trip
Local Trips
Readings:
Beginning of Month
End of Month
Trips
Days
Total Miles
FM-12e
STATE OF NORTH CAROLINA
DEPARTMENT OF ADMINISTRATION
Rate per Mile
Motor Fleet Management Division, Raleigh
Mileage Charge
TRAVEL LOG
Monthly Fee
$35.00
FOR PERMANENTLY ASSIGNED VEHICLES
Total Amount
Department
Agency
Dept./Off. No.
Fund No.
RCC No.
Vehicle No.
Individual Responsible for Vehicle:
Approval of Agency Head or Supervisor:
For Month Of
TRIP DATES
OFFICIAL TRAVEL
MILEAGE
From
To
Purpose of Trip
Signature
Out
In
Miles
Leave Return
Odometer
No. of
No. of Trip
Local Trips
Readings:
Beginning of Month
End of Month
Trips
Days