The Commonwealth of Massachusetts

Operational Services Division

Office of Vehicle Management

VEHICLE / ASSET / DRIVER REASSIGNMENT

Asset Information

License Plate No.: / VIN:
Year/Make/Model:
Type(select one): / Passenger VehiclePickup Truck
Large Van (cargo/pass)Trailer/Equipment / Mileage:

Reassignment Information

From

Agency: / UnitCode:
Address, City, Zip:
Agency Fleet Manager:
(name andtitle) / Phone and Email:
Agency CFO:
(name and title) / Phone and Email:
Driver Name:
(first and last)

To

Agency: / Unit Code:
Address, City, Zip:
Agency Fleet Manager:
(name and title) / Phone and Email:
Agency CFO:
(name and title) / Phone and Email:
Driver Name:
(first and last)

Justification for Reassignment

If typing in Word, this text box will expand (please attach additional documentation if necessary).

Signature

Agency Fleet Manager: ______Date:

FOR OVM USE ONLY
OVM Fleet Director:______Date Received:______

VEHICLE REASSIGNMENT - 12/2017

This form must be submitted to OVM when any vehicle or fleet asset is reassigned within an Agency (to either a different assigned driver or a different Unit Code) or when Agencies are transferring owned vehicles or fleet assets to another Agency.

Leased vehicles may not be transferred between Agencies without obtaining approval from OVM prior to the transfer. Additional documentation may be required.

Any transfer or reassignment of a fleet asset that will result in an increase to the overall size of an Agency’s fleet must be approved by OVM prior to the transfer or reassignment. Additional documentation may be required.

Instructions:

Asset Information

  • License Plate No. – Provide the Registry of Motor Vehicles’ license plate number assigned to the vehicle, trailer, or equipment, or indicate if confidential.
  • Vehicle Identification Number (VIN) – Provide the VIN for the vehicle, trailer, or equipment.
  • Year/Make/Model – Provide the year,manufacturer,and model name of the vehicle, trailer, or equipment.
  • Type – Check the appropriate box indicating if the vehicle is a passenger vehicle, pickup truck, large van (cargo/passenger), or trailer/equipment.
  • Mileage – Provide the odometer (or hour meter)reading for the vehicle on the day the form is completed.

Reassignment Information

From

Agency–Provide the complete name of the Agency where the assetcurrently is assigned.

  • Unit Code – Provide the Unit Code (billing detail) for the Agency location where the assetcurrently is assigned.
  • Address, City, Zip: – Provide complete address of the current location of the asset, including city and zip code.
  • Agency Fleet Manager – Provide complete name and title of the employee designated as Agency Fleet Manager.
  • Phone and Email – Provide phone number (including area code) and email address of Agency Fleet Manager.
  • Agency CFO – Provide complete name and title of the employee designated as Agency Chief Financial (or Fiscal) Officer, or the designated financial signatory.
  • Phone and Email – Provide phone number (including area code) and email address of CFO.
  • Driver Name – Provide complete name of driver currently assigned to the asset.

To*

Agency–Provide the complete name of the Agency where the asset currently is assigned.

  • Unit Code – Provide the Unit Code (billing detail) for the Agency location where the asset currently is assigned.
  • Address, City, Zip: – Provide complete address of the current location of the asset, including city and zip code.
  • Agency Fleet Manager – Provide complete name and title of the employee designated as Agency Fleet Manager.
  • Phone and Email – Provide phone number (including area code) and email address of Agency Fleet Manager.
  • Agency CFO – Provide complete name and title of the employee designated as Agency Chief Financial (or Fiscal) Officer, or the designated financial signatory.
  • Phone and Email – Provide phone number (including area code) and email address of CFO.
  • Driver Name – Provide complete name of driver currently assigned to the asset.

*write “SAME” if not changing a particular section

Justification for Reassignment – Provide a validation for the asset reassignment.

Sign and date the form by Agency Fleet Manager.

Return completed form to Office of Vehicle Management via email to . OVM will accept the signed form in Word or via Adobe pdf format.