Tool Order

Label Info

  • Tech Name

  • Tech Number

  • Van Number

Tool Information

  • * Items submitted as lost or broken will be payroll deducted.

  • * Items submitted as not issued will require FSM or Fleet Manager approval.

  • * Items submitted as worn require the explanation below, a photo of worn item, and FSM approval.

Single Items

  • Part# & Item Description

  • Cause

  • Explanation for Worn

  • Add media

  • Do you require additional Tools?

  • Part# & Item Description

  • Cause

  • Explanation for Worn

  • Add media

  • Do you require additional Tools

  • Part# & Item Description

  • Cause

  • Explanation for Worn

  • Add media

  • Do you require additional Tools

  • Part# & Item Description

  • Cause

  • Explanation for Worn

  • Add media

Multiple Items

  • Do you require additional tools

  • Part# & Item Description

  • Quantity

  • Cause

  • Explanation for Worn

  • Add media

  • Do you require additional tools

  • Part# & Item Description

  • Quantity

  • Cause

  • Explanation for Worn

  • Add media

  • Do you require additional tools

  • Part# & Item Description

  • Quantity

  • Cause

  • Explanation for Worn

  • Add media

  • Do you require additional tools

  • Part# & Item Description

  • Quantity

  • Cause

  • Explanation for Worn

  • Add media

Charges, Cost of Items, plus Tax

  • Total Cost of items being charged: Sub Total

  • Tax

  • Total to be Charged

  • *The item(s) that you are being charged for have been identified above, the total being listed above.

  • The amount owed will be deducted from your paycheck(s) per the following schedule

  • 1st Amount to be charged

  • 1st Pay Period Ending Date

  • 2nd Amount to be charged

  • 2nd Pay Period Ending Date

  • 3rd Amount to be charged

  • 3rd Pay Period Ending Date

  • Deductions taken out over multiple pay periods need FSM/ROM approval

Authorization

  • I hereby acknowledge and agree that I have filled out the above form to the best of my ability, and agree to the appropriate charges.

DRS Purchasing

  • Date:

  • Fax Date:

  • Defective Item Returned:

  • HD PO#:

  • DOW SO#:

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