Supplementary Work Diary Record - National Driver Work ...
ORIGINAL (to remain in the book) Driver's Name: Licence No:
Supplementary work diary record
NATIONAL DRIVER WORK DIARY DAILY SHEET
Number Plate:
Date:
DRIVER IDENSTIFIMCATITONW T F S Day of the Week:
SMTWT F S
Time Zone: State/Territory (Driver Base)
ACT NSW NT QLD SA TAS VIC WA
Driver
Standard
BFM
WORK DIARY NO.
201405-0028
Standard Bus
Time of daily check (if required):
AFM
(for this 24 hr period only)
DETAILS OF ACTIVITIES FOR THIS DAY
Number Plate Change and Comments
(e.g. delays, authorised
Odometer Reading
Name of Place at Work and Rest Change
(e.g. rest area, truck stop,
suburb or town)
DO NOT DRIVE IF YOU ARE IMPAIRED BY FATIGUE Spaceforyoutocalculate your work and rest hours
Two-up
1 midnight
2
3
4
5
6
7
8
9 10 11 noon 1
2
3
4
5
6
7
8
9 10 11 midnight
All drivers: calculate totals
Total Work:
My Work
My Rest
Total Rest:
1 midnight 2 3 4 5 6 7
Driver Signature:
daily sheet is true and correct
YOU MUST SIGN THIS SHEET BEFORE STARTING A NEW DAILY SHEET
8 9 10 11 noon 1 2 3 4 5 6 7 8 9 10 11 midnight
Two-up Driver's Name:
TWO-UP DRIVER'S IDENTIFICATION
Two-up Driver's Licence No:
Two-up Driver
Standard BFM AFM
Two-up Driver's Work Diary & Page No: Two-up Driver's Licence issued:
Two-up Driver's Signature:
ACT NSW NT QLD SA TAS VIC WA
hours
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