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DRIVER S TIME RECORD Driver s Name Print MonthYr COMPANIES MAY PREPARE THIS REPORT INSTEAD OF DRIVER S DAILY IF THE FOLLOWING APPLIES Driver operates within 100-air mile radius of headquarters. Driver returns to headquarters and is released from work within 12 consecutive hours. Driver has at least 10 consecutive hours off duty between each 12 hour shift. Date Start Time All Duty End Time Total Hours Driving Intermittent Drivers Shall complete this form for 7 days preceding any day driving is performed* This includes the preceding month. Driver returns to headquarters and is released from work within 12 consecutive hours. Driver has at least 10 consecutive hours off duty between each 12 hour shift. Date Start Time All Duty End Time Total Hours Driving Intermittent Drivers Shall complete this form for 7 days preceding any day driving is performed* This includes the preceding month. .

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