Van Details  
  Employee Van Usage Exclusive    
  Van Regn. No. 5466ou First Regn. Date 05/05/2001
  Make Isuzu Standard Charge 500.00  
  Model Trooper 3.0TD Fuel Standard Charge 500.00  

Exclusive Use Van Details  
  Van first made available date Date of Birth
(DD/MM/YYYY)
Van last used date Date of Birth
(DD/MM/YYYY)
  Van Usage    
  Particulars Days
  Days the van was unavailable exclusively for 30 or more Days consecutively during the benefit availability period
  Days the van was put to shared use during the benefit availability period
  Total Number of days the van was unavailable or shared
  Particulars Amount
  Proportionate Standard charge for actual no. of days benefit was available G1
  Amount of contribution made by the employee for private use of this van G2
  Total Cash Equivalent for this Van for the employee ( G1 minus G2 ) G

Van Fuel Details  
  Company Provides Fuel
   
  Fuel Supply Start Date Date of Birth
(DD/MM/YYYY)

Fuel Supply Withdrawn Date Date of Birth
(DD/MM/YYYY)

  Does Employee repay fuel cost for private use? Fuel Cash Equvalent