Engineer Name

Engineer Name

Engineer Number

Team code

Van Registration

Local Authority


Date fine occurred

Job Number

Road name

Authorised to pay

Authorised to recharge engineer

Reason for not recharging engineer

Photo of notification of parking issue before receiving fine
Photo of fine, vehicle parked and signage displaying terms

Team Manager submitting form

Date submitted and emailed to UTL
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.