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DAS Fleet Services - Driver's License Verification Form
Pursuant to Iowa Administrative Code 11 IAC 103.6, a state driver shall not drive a state or private vehicle on state business if the state driver does not currently possess a valid driver’s license with the appropriate classifications, restrictions and endorsements. Completion and submittal of this form enables DAS Fleet Services to verify the driver has a valid driver's license at time of submittal. Licenses will be monitored as long as the individual is an active and authorized driver of the State to ensure compliance per 11 IAC 103.
All drivers are expected to read and follow all provisions contained in the
State Employee Driving Guidelines
and the
DAS Policies and Procedures Manual
.
Please read through the Accident Report Form and flowchart.
https://das.iowa.gov/sites/default/files/fleet/pdf/AccidentReportForm.pdf
https://das.iowa.gov/sites/default/files/fleet/pdf/AccidentClaimFlowchart.pdf
*Form must be submitted in Google Chrome or Safari.* (Form updated 2/13/2020)
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FUEL CARDS
State of Iowa fleet vehicles fueled at retail locations must be fueled using a state-issued Fuel Card, which requires a personal identification number (PIN). By checking this box and requesting a Fuel Card PIN, I understand and agree:
* The State Fuel Card can only be used for fuel and allowed purchases (incidental expenses and emergencies). It shall not be used for vehicle maintenance, repairs, or any non-state business purposes.
* When refueling, both the driver PIN and current odometer reading must be entered.
* Fuel Cards assigned to a vehicle cannot be used for another vehicle.
* Driver PINs are assigned to individual authorized drivers and cannot be shared.
Do you need a Fuel Card PIN?
Yes
DRIVER INFORMATION
State of Iowa Employees or Authorized Driver for the State of Iowa.
First Name (Legal Name)
*
Your answer
Middle Name (Legal Name)
Your answer
Last Name
*
Your answer
Driver's License Number
*
Your answer
Driver's License Issuing State
*
Your answer
State Agency
*
Choose
Administrative Services 005
Agriculture and Land Stewardship 009
State Fair 34
Attorney General's Office 112
Office of Consumer Advocate 114
Auditor of State 126
Department for the Blind 131
Iowa Ethics and Campaign Disclosure Board 140
Iowa Civil Rights Commission 167
Office of Chief Information Officer 185
Commerce - Alcoholic Beverages Division 212
Commerce - Banking Division 213
Commerce - Credit Union Division 214
Commerce - Insurance Division 216
Commerce - Professional Licensing Division 217
Commerce - Utilities Division 219
Community Based Corrections - District 1 - 221
Community Based Corrections - District 2 - 222
Community Based Corrections - District 3 - 223
Community Based Corrections - District 4 - 224
Community Based Corrections - District 5 - 225
Community Based Corrections - District 6 - 226
Community Based Corrections - District 7 - 227
Community Based Corrections - District 8 - 228
Corrections - Central Office 238
Corrections - Iowa State Penitentiary (Fort Madison) 242
Corrections - Anamosa State Penitentiary 243
Corrections - Iowa Medical and Classification Center (Oakdale) 244
Corrections - Newton Correctional Facility 245
Corrections - Mt. Pleasant Correctional Facility 246
Corrections - North Central Correctional Facility (Rockwell City) 247
Corrections - Clarinda Correctional Facility 248
Corrections - Iowa Correctional Institution for Women (Mitchellville) 249
Corrections - Iowa Prison Industries 250
Corrections - Anamosa Farm Accounts 251
Corrections - Fort Dodge Correctional Facility 252
Cultural Affairs 259
Iowa Economic Development Authority 269
Iowa Finance Authority 270
Education 282
Education - Library 287
Vocational Rehabilitation 283
College Student Aid Commission 284
Iowa PBS 285
Board of Educational Examiners 286
Department on Aging 297
Iowa Workforce Development 309
Iowa Communications Network 336
Governor's Office 350
Human Rights 379
Human Services 401
Human Services - Community Services 402
Human Services - Toledo Juvenile Home 404
Human Services - Eldora State Training School 405
Human Services - Civil Commitment Unit for Sexual Offenders 406
Human Services - Cherokee Mental Health Institution 407
Human Services - Clarinda Mental Health Institution 408
Human Services - Independence Mental Health Institution 409
Human Services - Mt. Pleasant Mental Health Institution 410
Human Services - Glenwood Resource Center 411
Human Services - Woodward Resource Center 412
Human Services - Assistance Payment 413
Department of Inspections and Appeals 427
Inspections and Appeals - State Public Defender 428
Inspections and Appeals - Racing and Gaming Commission 429
Judicial Branch 444
Iowa Law Enforcement Academy 467
Legislative - House 500
Legislative - Senate 501
Legislative - Joint Expenses 502
Legislative - Office of Ombudsman 503
Legislative Services 504
Department of Management 532
Department of Natural Resources 542
Board of Parole 547
Iowa Public Employees Retirement System (IPERS) 553
Public Employment Relations Board 572
Public Defense 582
Iowa Homeland Security and Emergency Management Department 583
Public Health 588
Public Safety 595
Revenue 625
Lottery 627
Secretary of State 635
Governor's Office of Drug Control Policy 642
Treasurer of State 655
Veterans Affairs 670
Iowa Veterans Home 671
Board of Regents 615
Official Work Address
*
Your answer
Is this a temporary position?
Choose
Yes
No
Is this a personal residence?
*
Choose
Yes
No
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