Department of Transportation

DOH Forms

Public Use WVDOH Forms​

  
  
  
  
BF-23.xlsBF-23Daily Permit and Map Sales RecordFinance
DD-01.pdfDD-01Dig Once Legal Advertisement TemplateEngineering
DT-10.pdfDT-10Outdoor Advertising Sign PermitTraffic Engineering
DT-11.pdfDT-11Application For Changeable Message Sign PermitTraffic Engineering
DT-12.pdfDT-12Application For An Outdoor Advertising LicenseTraffic Engineering
DT-57.pdfDT-57Roadside Memorial Sign ApplicationTraffic
OrderPlanPropX-S.docOrderPlanPropX-SOrder Form for Proposals, Plans & X-SectionsContract Administration
SalvageYardApplication.pdfSalvageYardApplicationSalvage Yard ApplicationTraffic

 

Internal Use Only WVDOH Forms​

  
  
  
  
6MonthEquipmentEvaluation.pdf6MonthEquipmentEvaluation6 Month Equipment EvaluationEquipment
AH-01.docAH-01Employees in AttendanceHuman Resources
AH-03.docAH-03Employee Evaluation Form (training course)Human Resources
AH-04.docAH-04Overall Rating Form (training course)Human Resources
AH-05.pdfAH-05Summer Employee Appraisal
AR-13.docxAR-13REPORT OF MOTOR VEHICLE ACCIDENT (AR-13)
Assignment of Future Wages.docAssignment of Future WagesAssignment of Future WagesHuman Resources
AW-508.docAW-508Employee Verification (salary)Human Resources
AW-509.docAW-509Employee Verification (hourly)Human Resources
BF-129P.docBF-129PPAYROLL TRANSACTION - PARKING DEDUCTION (BF-129P)Finance
BF-155.docBF-155Use of State Vehicle for CommutingFinance
BF-30.docBF-30Official Station AssignmentFinance
BF-30A.docBF-30AOfficial Station Assignment LogFinance
BF-56.xlsBF-56TransmittalFinance
BF-98C.docBF-98CVerbal AuthorizationFinance
BI-125.pdfBI-125Claim Reopening ApplicationHuman Resources
BI-309.pdfBI-309Return to Work NoticeHuman Resources
CRF.pdfCRFCost Report FormLegal
DOH-20.pdfDOH-20Operator's Qualification ReportEquipment
DOH-21.pdfDOH-21Take Home Vehicle Assignment CriteriaExecutive
DOH-45.docDOH-45Long Distance Toll CallsFinance
DOH-55.pdfDOH-55WVDOH Request For Assignment of a Transportation Vehicle
DOH-56.pdfDOH-56WVDOH Vehicle Log Sheet
DOH-57.pdfDOH-57WVDOH Vehicle Use Agreement
DOH-8.docDOH-8Building and Grounds Work OrderDistrict/Division/Finance
Election of Option.pdfElection of OptionWorkers' Compensation Temporary Total Disability Benefits or Sick Leave Benefits Election of OptionHuman Resources
EO-470.docxEO-470DBE CONTRACTOR'S PERFORMANCE REPORT
EQPolicyAcknowledgementStatement.pdfEQPolicyAcknowledgementStatementEquipment Operator Accounability PolicyEquipment
Excess Hours Reporting form.xlsxExcess Hours Reporting formExcess Hours Reporting Form
GL-1.xlsxGL-1Underground Storage Tank Monitoring LogEquipment
GL-4.docGL-4Employment FormHuman Resources
GL-5.docGL-5Transaction FormHuman Resources
GL-541.docGL-541Interview RecordHuman Resources
GL-542.xlsxGL-542DOH Rate Calculator
GL-6.docGL-6Education/License/Skills RecordHuman Resources
GS-41.pdfGS-41Micro-Film RequestOffice Services
i-9.pdfi-9Employment Eligibility VerificationHuman Resources
ME-114.docME-114Field Report InformationEquipment
ME-115-Field-Report-Tank.pdfME-115-Field-Report-TankField Report TankEquipment
MQ-39.docMQ-39Equipment PurchasesEquipment
OE-200.docOE-200Fabrication Welding VerificationEquipment
OE-90.pdfOE-90Agency Bill of SaleEquipment
OE-97.pdfOE-97Equipment Evaluation FormEquipment
OM-41.xlsOM-41Maintenance Schedule WorksheetMaintenance
OM-79.pdfOM-79Changes to the State Highway SystemMaintenance
OvertimeWorkedWorksheet.pdfOvertimeWorkedWorksheetOvertime Worked/Emergency WorksheetMaintenance
PL-1.pdfPL-1Pay Plan Policy: Request For ApprovalHuman Resources
RL-545.docRL-545Notice to Employee of Immediate Oral Suspension Followed by Written Notice and an Opportunity to RespondHuman Resources
RL-551.docRL-551Application and Interview LogHuman Resources
Safety Awards Nominations Form.xlsxSafety Awards Nominations FormSafety Awards Nominations Form
SC-477.pdfSC-477Daily Work Record SC-477
ScheduledOvertimeWorksheet.pdfScheduledOvertimeWorksheetScheduled Overtime WorksheetMaintenance
SM-100.xlsSM-100Hot-Laid Bituminous Concrete Project CostMaintenance
SM-102.xlsSM-102Aggregate - Low Bid ComputationMaintenance
SM-93.docSM-93Statement of AcceptanceMaintenance
TreasuryOffsetVerificationForm.pdfTreasuryOffsetVerificationFormTreasury Offset Verification FormFinance