Spreadsheet: 37229eb7-846e-4889-a82d-875cb67d839b
Sheet: Sheet1

Commonwealth of Pennsylvania | Unnamed: 1 | Unnamed: 2 | Unnamed: 3 | Unnamed: 4 | Unnamed: 5 | Unnamed: 6 | Unnamed: 7 | Unnamed: 8 | Unnamed: 9 | Unnamed: 10 | Unnamed: 11 | Unnamed: 12 | Unnamed: 13 | Unnamed: 14 | VEHICLE INVENTORY CHANGE REPORT | Unnamed: 16 | Unnamed: 17 | Unnamed: 18 | Unnamed: 19 | Unnamed: 20 | Unnamed: 21 | Unnamed: 22 | Unnamed: 23 | Unnamed: 24 | Unnamed: 25 | Unnamed: 26 | Unnamed: 27 | Unnamed: 28 | Unnamed: 29 | Unnamed: 30 | Unnamed: 31 | Unnamed: 32 | Unnamed: 33 | Unnamed: 34 | Unnamed: 35 | Unnamed: 36 | Unnamed: 37 | Unnamed: 38 | Unnamed: 39 | Unnamed: 40 | Unnamed: 41 | Unnamed: 42 | Unnamed: 43 | Unnamed: 44 | Unnamed: 45 | Unnamed: 46 | Unnamed: 47
Department of General Services
GSVM-88 (Rev.11/11)
To: |  | Vehicle Administration Division |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | REQUESTED BY: |  |  |  |  |  |  |  |  | (Department, Board or Commission) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | EFFECTIVE DATE
 |  | Bureau of Vehicle Management
 |  | 2221 Forster St.
CREDIT CARD REQUEST |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Equipment Number |  |  |  |  |  |  | - |  |  |  |  |  | -
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | License Plate Number
 |  |  |  |  |  |  |  |  |  |  |  |  | OLD ICS:
 |  |  |  |  |  |  |  |  |  |  |  |  | Fund |  |  |  |  |  | Dept. |  |  |  |  |  | App. |  |  |  |  |  | Year |  |  |  | Leg |  | Org. |  |  |  |  |  |  |  | Cost Center (Function)
Part I
 |  |  |  |  |  |  |  |  |  |  |  |  | OLD SAP CODING     Fund |  |  |  |  |  |  |  |  |  |  |  |  |  | Cost Center |  |  |  |  |  |  |  |  |  |  |  |  |  | Internal Order
 |  | Coding Change
 |  | Replacement of Lost/Stolen Credit Card |  |  |  |  |  |  |  |  |  |  | OLD VOYAGER ACCOUNT NO.
 |  |  |  |  |  |  |  |  |  |  |  |  | NEW ICS: Fund |  |  |  |  |  | Dept. |  |  |  |  |  | App. |  |  |  |  |  | Year |  |  |  | Leg |  | Org. |  |  |  |  |  |  |  | Cost Center (Function)
 |  | Replacement of Defaced Credit Card
 |  |  |  |  |  |  |  |  |  |  |  |  | NEW SAP CODING       Fund |  |  |  |  |  |  |  |  |  |  |  |  |  | Cost Center |  |  |  |  |  |  |  |  |  |  |  |  |  | Internal Order
 |  | Other                                 _____________________
 |  |  |  |  |  |  |  |  |  |  |  |  | NEW VOYAGER ACCOUNT NO.
Part II - DRIVER'S INFORMATION |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Did [NAME] transfer from another agency? ________Yes      ________No
 |  | Vehicle Operator |  |  |  |  |  |  |  |  |  |  | Executive Vehicle |  |  |  |  |  |  |  | New Driver / Employee |  |  |  |  |  | If yes, what Agency __________________________________________
 |  | Location Change |  |  |  |  |  |  |  |  |  |  | Executive [NAME] |  |  |  |  |  |  |  | Controlled Exec Driver |  |  |  |  |  | Operator's Job Title
 |  |  |  |  |  |  |  |  | (First Name) |  |  |  |  |  |  |  |  |  |  |  |  |  | (Last Name)
Driver's Name
 |  |  |  |  |  |  |  |  | (First Name) |  |  |  |  |  |  |  |  |  |  |  |  |  | (Last Name)
[NAME]'s Name                          If Pool
Driver's Operator License Number |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Driver's Employee Number
Vehicle Overnight Location:
Street Address
Town or City
County Name |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Zip Code |  |  |  |  |  |  |  |  |  |  |  |  |  | Home |  |  |  |  |  |  |  | Work |  |  |  | [NAME]
Part III - LICENSE / REGISTRATION / PLATE REQUESTS / INSURANCE CARD / WEIGHT CLASS STICKER
 |  | Assignment of License Plate (Attach Form               GSVM-95 for Confidential License Plate). |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Confidential or PA to Fictitious |  |  |  |  |  |  |  |  |  |  |  | Request for Duplicate                                     ____ Registration        ____ Sticker |  |  |  |  |  |  |  |  |  |  |  | Renewal Sticker Date
 |  | Defaced License Plate.  Issue New Plate to Replace Plate Number. |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Fictitious to                 ___Confidential or ___PA |  |  |  |  |  |  |  |  |  |  |  | Insurance Card
 |  | PA to Confidential |  |  |  |  |  |  |  |  | Confidential to PA |  |  |  |  |  |  |  |  |  | For Lost License Plate |  |  |  |  |  |  |  |  |  |  |  | Duplicate Weight                     Class Sticker #
q VEHICLE ADMINISTRATION USE ONLY   q
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | New License Plate Number
Year |  |  |  |  |  |  | Make |  |  |  |  |  |  |  |  |  |  |  | Model |  |  |  |  |  |  |  |  |  |  |  | Credit Card Coding
[NAME]. Plate |  |  |  |  |  |  |  |  | Date Ordered |  |  |  |  |  |  |  |  |  |  |  | Date Received
Serial Number |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Title Number
Card Number:
Signature (Automotive Liaison) |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Date