This form must be filled out when employees have been authorized to use privately owned vehicles to conduct official business.

The vice presidents have been delegated authority to approve leaves of absence without pay.

Please print on pink paper.

This form must be completed and approved by the building coordinator and the Risk Manager at least 1 (one) week prior to the event. *Refer to the list of Building Coordinators at http://www2.humboldt.edu/facilitymgmt/building-coordinators