General Car Details (*) = Required field
  Car Regn. No. M186 HCM Date of Purchase  
  Make Ford Model Mondeo
  MOT date   Color  
  Year 2002    

Capital Car Value  
  Purchased Price     Optional Accessory Cost 0.00  
  List price 5598.00   Classic Car Value 0.00  
  Capital Contribution to Car Accessory added after Car was first provided to Employee

Car Usage  
  Car First Available Date Date of Birth
(DD/MM/YYYY)		 Car Last Used Date Date of Birth
(DD/MM/YYYY)
  Date first regd. 05/05/1999 Fuel / Power type Gas / Bi-fuel
  Engine size   Approved CO2  
  Car Usage Car Facilitated
  Total annual contribution Frequency of contribution
  Total Car unavailable days Car unavailable reason

Fuel Usage  
  Company Provides Fuel Fuel Usage Purpose
  Fuel Supply Start Date Date of Birth
(DD/MM/YYYY)		 Fuel Supply Withdrawn Date Date of Birth
(DD/MM/YYYY)
  Was fuel reinstated in current tax year ? Fuel Supply Reinstated Date Date of Birth
(DD/MM/YYYY)
  Does Employee repay fuel cost for private use ?