BASF SE

ESM/WW –J 660
Tel. +49 621 60-46196

E-Mail:

67056 Ludwigshafen, Germany

Before filling in this form, please refer to notes below. *indicates mandatory field; application cannot be processed if incomplete.

Application for vehicle entry permit (VEP)(see note[1])

What do you require?*:

General VEP(s)

Renewal of existing VEP(s)

Until when should the VEP be valid? (max. 1 year)(TT/MM/JJJJ)*:

Date of application(TT/MM/JJJJ) *:

Details of external contact*

Surname, first name:

Phone:

E-mail:

Name of contractor (company):

Company stamp and signature*

Permitted person/s to collect the VEP(s)

Surname, first name:

Surname, first name:

Surname, first name:

Number of Vehicle(s)*
or
current VEP number in case of request for renewal / Type of vehicle*
(see vehicle registration certificate)
If the vehicle type is not listed in the drop-down menu, please enclose of photocopy of the vehicle’s registration certificate)
please choosePKWother vehicle (no PKW)
please chooseLKWSonder-KfZKranOmnibusMehrzweckfahrzeugVanBusPKWTransporter
please chooseLKWSonder-KfZKranOmnibusMehrzweckfahrzeugVanBusPKWTransporter
please chooseLKWSonder-KfZKranOmnibusMehrzweckfahrzeugVanBusPKWTransporter
please chooseLKWSonder-KfZKranOmnibusMehrzweckfahrzeugVanBusPKWTransporter
please chooseLKWSonder-KfZKranOmnibusMehrzweckfahrzeugVanBusPKWTransporter

To be completed by a BASF contact person or manager*

Surname, first name:

Code – Building:, Tel. , E-mail:

Check box below as appropriate*:

Iagree to the issue of a VEP for the above vehicle(s)

IDO NOT agree to the issue of a VEP for any of the above vehicle(s)

Ionly agree to the issue of a VEP for some of the above vehicles for the following reason

Date/signature of BASF person responsibleor in the case of leasing, the employing unit*:

______

Notes

VEPs can be collected from the Pass Office (Ausweisstelle in building J660) twoworking days after receipt of the approved application. The VEPs can only be collected by the person/s you named on the application. The person has to possess a valid BASF-ID card from the main contractor.

VEPs, which are not collected after six weeks, will be destroyed.

Notes for filling in the form

November 2017

[1]Only the main contractor (not their sub-contractors/leasing companies) may apply for VEP(s) from the Pass Office (ESM/WWA – Ausweisstelle). VEPs are valid for up to one year. The VEP is issued in the name of the main contractor and may be used by both the main contractor and subcontractor(s). The main contractor is responsible for the VEP

Be sure to use the current application form, which you can download from

Out-of-date forms will not be accepted.

  1. Complete and print out the form on a computer (forms completed by hand will not be accepted).
  2. Get the form stamped and signed by your manager/supervisor.
  3. Get the form approved and signed by the responsible BASF person, who will then e-mail it to ESM/WW – J 660

„Other vehicle“ includes every vehicle which is no passenger car (PKW).

A passenger car „PKW“ includes (please check your vehicle registration certificate):

  • Cabrio-Limousine
  • Coupe
  • Kombilimousine
  • Limousine
  • Pkw
  • Pkw-Pick-up
  • Schräghecklimousine