DOT Forms

 

  
  
  
  
Acknowledgement.pdfAcknowledgementConfidentialityAgreementInfoSecurityAcknowledgementHuman Resources
ah-501.docah-501CONCERNS FOR DISCUSSION - EMPLOYEE EVALUATIONS (AH-501)Human Resources
ah-503.docah-503RECORD OF SIGNIFICANT OCCURRENCE (AH-503)Human Resources
AH-505.docAH-505REASONABLE SUSPICION DOCUMENTATION (AH-505)Human Resources
AppDonAL.docAppDonALApplication to Donate Annual LeaveHuman Resources
appexam.docappexamDivision of Personnel Application for ExaminationDivision of Personnel
appexamsup.docappexamsupDivision of Personnel Application for Examination - Employment History Supplemental FormDivision of Personnel
AppForPaymentofUnusedSickLeave.pdfAppForPaymentofUnusedSickLeaveApplication for Payment of Unused Sick Leave & Reimbursement AgreementDivision of Personnel
AppRecDL.docAppRecDLApplication to Receive Donated LeaveHuman Resources
asinwage.docasinwageAssignment of Future WagesFinance/Payrolll
bf-143.xlsbf-143Journal Voucher (BF-143)Finance
bf-150.docbf-150Financial End Date Adjustment and Project Completion NotificationFinance
BF-150.docxBF-150Financial End Date Adjustment and Project Completion Notification
bf-2.xlsbf-2CONSULTANT VOUCHER (BF-2)Finance
bf-38.xlsbf-38INVOICE (BF-38)Finance
BF-52.pdfBF-52NON-CONTRACT CLOTHING/APPAREL RELATED PURCHASE JUSTIFICATION AND APPROVAL FORMFinance/P-Card Coordinator
bf-98.xlsbf-98AUTHORIZATION (BF-98)Finance
BI-14.pdfBI-14WVDOT Policy And Procedure Request FormInformation Services
bi-15.docbi-15REQEST FOR SERVICES (BI - 15)Information Services
bz-24.docbz-24REQUEST FOR PHOTOGRAPHIC SERVICES (AO-24)Office Services
ConfidentialityAgreement.pdfConfidentialityAgreementConfidentiality AgreementHuman Resources
DOP 160-Day Temp Appt.docDOP 160-Day Temp Appt160-Day Temporary AppointmentHuman Resources
DOP-AdditionalDutiesPostingNotice.pdfDOP-AdditionalDutiesPostingNoticeDivision of Personnel Additional Duties Posting NoticeDivision of Personnel
dot-1.docdot-1DOCUMENT CONTROL LOG (DOT-1)Finance
dot-104.docdot-104TRANSMITTAL (DOT-104)Finance
dot-104.xlsdot-104TRANSMITTAL LETTER (DOT-104)Finance
dot-105.xlsdot-105SMALL PURCHASE REQUISITION (DOT-105)Finance/Procurement
dot-105B.xlsdot-105BTELEPHONE BID DOC. & LOW-BID DETERMIN.(DOT-105B)Finance/Procurement
dot-105f.xlsdot-105fDOT FAX ORDER (DOT-105F)Finance/Procurement
dot-114.docdot-114STOLEN OR MISSING PROPERTY (DOT-114)Finance/Procurement, Equipment, Highway Operations
dot-12.docdot-12DAILY WORK REPORT (DOT-12)Finance, Equipment, Highway Operations
dot-129.docdot-129Payroll/Benefits Transaction Form (DOT-129)Finance
dot-12A.docdot-12AREQUEST FOR PAYROLL CORRECTION (DOT-12A)Finance
dot-12L.docdot-12LLABOR REPORT (DOT12L)Finance
dot-12LE.docdot-12LELABOR & EQUIPMENT REPORT (DOT-12LE)Finance, Equipment
dot-19.docdot-19DOCUMENT TRANSMITTAL (DOT-19)Finance/Procurement
dot-2.docdot-2WEST VIRGINIA DEPARTMENT OF TRANSPORTATIONFinance
dot-22.docdot-22PRINTING SERVICES REQUEST (DOT-22)Office Services
dot-25.docdot-25Business Card Order Form (DOT-25)Office Services
dot-3.docdot-3PURCHASE ORDER CONTROL LOG (DOT-3)Finance/Procurement
dot-35.xlsdot-35PURCHASING REQ. & CODE SHEET (DOT-35)Finance/Procurement
DOT-357.docDOT-357SYSTEM SECURITY REQUEST (DOT-357)Information Services
DOT-35A.xlsDOT-35APURCHASING REQUISITION/QUOTATIONS (DOT-35A)Finance/Procurement
DOT-49.pdfDOT-49Out of State Travel RequestFinance
dot-5.xlsdot-5RECEIPT OF MATERIALS/SERVICES RECORD (DOT-5)Finance/Procurement
dot-504.docdot-504EMPLOYMENT FORM (DOT-504)Human Resources
DOT-508.pdfDOT-508Departing Employee Check Sheet, DOT-508Human Resources
dot-534.docdot-534FORM DOT-534Human Resources
dot-55P-2006.docdot-55P-2006REQUEST FOR PERSONAL VEHICLE USE (DOT-55P)Finance
dot-6.xlsdot-6INVENTORY USAGE OR TRANSFER (DOT-6)Finance/Procurement
dot-6.xlsxdot-6INVENTORY USAGE OR TRANSFER (DOT-6)
dot-65.docdot-65EQUIPMENT METER READINGS & METER STATUS (DOT-65)Equipment
DOT-6A.pdfDOT-6ARequest for Inventory Write-OffFinance/Procurement
dot-6aa.xlsdot-6aaREQUEST FOR PARTS/MATERIALS/SUPPLIES INVENTORY WRITE-OFF - ATTACHMENTFinance/Procurement
dot-877.docdot-877FIXED ASSETS INVENTORY FIELD REPORT (DOT-877)Finance/Procurement
dot-91.docdot-91TRANSFER OR STATUS CHANGE OF EQUIPMENT(DOT-91)Highway Operations, Equipment
DOT-911.pdfDOT-911Employee Injury and Fatality Checklist (DOT-911)Human Resources
doteo-1.docdoteo-1DISCRIMINATION COMPLAINT (EO-1)Human Resources
DOT-ITPolicyAcknowledgement.pdfDOT-ITPolicyAcknowledgementInformation Technology Policy Acknowledgement StatementInformation Services
DOTRemoteAccessRequest.pdfDOTRemoteAccessRequestRemote Access RequestInformation Services
edexpf1.docedexpf1Educational Expense Reimbursement ApplicationHuman Resources
edexpf2.docedexpf2Educational Expense Reimbursement Payment RequestHuman Resources
edexpf3.docedexpf3Educational Expense Reimbursement AgreementHuman Resources
EmployeeHandbookAcknowledgement.pdfEmployeeHandbookAcknowledgementEmployee Handbook AcknowledgementHuman Resources
EmpReimR.xlsEmpReimREmployee Reimbursement RequestFinance
EmpReimR.xlsxEmpReimREmployee Reimbursement Request
GL-2.xlsxGL-2PUMP STATION REPORTFinance/Procurement
GL-5.docGL-5TRANSACTION FORM (GL-5)Human Resources
GL-6.docGL-6EDUCATIONAL RECORD & SKILLS INVENTORY (GL-6)Human Resources
Grievance_Form.pdfGrievance_FormEducation and State Employees Grievance Board Form for State EmployeesHuman Resources
InformationSecurityAcknowledgment.pdfInformationSecurityAcknowledgmentInformation Security AcknowledgementHuman Resources
InstructionsforFuelPurch.pdfInstructionsforFuelPurchInstructions for Fuel PurchasesFinance/Procurement
MS-15.xlsMS-15Equipment/Materials Issue LogFinance/Procurement
NeligrLD.docNeligrLDNotice of Eligibility to Receive Donated LeaveHuman Resources
NewVPNLoginInstructions.pdfNewVPNLoginInstructionsVPN Login Instructions
NonConflict.pdfNonConflictCertification of Non-Conflict of InterestFinance/Procurement
OIC-WC-1-JZ.pdfOIC-WC-1-JZEmployee's and Physician's Report of InjuryHuman Resources
P-CardAgree.pdfP-CardAgreeState of West Virginia Purchasing Cardholder AgreementFinance/Procurement
P-CardComplaint.pdfP-CardComplaintState of West Virginia Purchasing Card Vendor Complaint FormFinance/Procurement
PCardCoordLogs.xlsPCardCoordLogsState of West Virginia Purchasing Card Coordinator's LogsFinance/Procurement
P-CardDispute.pdfP-CardDisputeCitibank® Government Cardholder Dispute FormFinance/Procurement
PCardLog.xlsPCardLogState of West Virginia Purchasing Card Log SheetFinance/Procurement
P-CardMaint.pdfP-CardMaintCitibank® Maintenance FormFinance/Procurement
P-CardSetup.pdfP-CardSetupCitibank® Commercial Card Setup FormFinance/Procurement
PII Access Request Form.pdfPII Access Request FormPersonally Identifiable Information Access Request FormExecutive
PII ACCESS REQUEST LOG.DOCXPII ACCESS REQUEST LOGPII Access Request Log
PII Access Response Form.pdfPII Access Response FormPII Access Response FormExecutive
PII Complaint Form.pdfPII Complaint FormPII Complaint FormExecutive
PII Incident Report.pdfPII Incident ReportPII Incident ReportExecutive
PII Instructions.pdfPII InstructionsPersonally Identifiable Information Forms - InstructionsExecutive
PosDescr.docPosDescrDivision of Personnel Position DescriptionDivision of Personnel
PreBidSignIn.pdfPreBidSignInPre-Bid Conference Sign-in SheetFinance/Procurement
PurchAffidavit.pdfPurchAffidavitState of West Virginia Purchasing Division Purchasing AffidavitFinance/Procurement
RL-544.docRL-544NOTICE TO EMPLOYEE: WARNING/DISCIPLINARY/CRIMINAL/SUSPENSION (RL-544)Human Resources
RL-546.docRL-546EMPLOYEE'S VERIFICATION OF DISCIPLINARY ACTION (RL-546)Human Resources
SoleSourceDeter.docSoleSourceDeterState of West Virginia Sole Source DeterminationFinance/Procurement
st-4.docst-4QUALITY ASSURANCE CERTIFICATION ( ST-4)Contract Administration
suggestion.pdfsuggestionState Employee Suggestion FormLegislative Services
TCR.docTCRTelecommunications Change RequestFinance/Procurement
tcr.docxtcrTelecommunications Change Request (TCR)
TMO3Hospform.pdfTMO3HospformHospitality DocumentationHuman Resources
TravelExpense07.xlsTravelExpense07State of WV Travel Expense Account SettlementFinance
UnitedTravelCardApp.pdfUnitedTravelCardAppUnited Bank West Virginia Travel Card ApplicationFinance
WarntyClmsSum.docWarntyClmsSumWarranty Claims SummaryEquipment
wv-1.pdfwv-1Vendor Registration and Disclosure StatementFinance/Procurement
wv-103.docwv-103Surplus Property DispositionFinance/Procurement, Office Services
wv-29.docwv-29RECORDS DISPOSAL REPORT (WV-29)Finance/Procurement
wv-35.xlswv-35PURCHASE REQUISITION (WV-35)Finance/Procurement
WV-36.docWV-36Purchase Continuation SheetFinance/Procurement
WV-36A.docWV-36APurchase Continuation SheetFinance/Procurement
wv-39.docwv-39BLANKET RELEASE ORDER (WV-39)Finance/Procurement
wv-48.docwv-48AGREEMENT (WV-48)Finance/Procurement
wv-48A.docwv-48AAGREEMENT (WV-48)Finance/Procurement
wv-50.docwv-50AGREEMENT REQUISITION (WV-50)Finance/Procurement
WV-82.docWV-82Vendor PerformanceFinance/Procurement
WV-96.pdfWV-96Agreement AddendumFinance/Procurement
wvempperap.xlswvempperapState of WV Employee Performance AppraisalHuman Resources
wvempperapade-main.xlswvempperapade-mainState of WV Employee Performance Appraisal for Assistant District Engineer - MaintenanceHuman Resources
wvempperapcha.xlswvempperapchaState of WV Employee Performance Appraisal for County Highway AdministratorHuman Resources
wvempperapeop.xlswvempperapeopState of West Virginia Employee Performance Appraisal for Transportation Worker 2 and 3 - Equipment OperatorHuman Resources
wvempperapma.xlswvempperapmaState of West Virginia Employee Performance Appraisal for Maintenance AssistantHuman Resources
wvempperaptcc.xlswvempperaptccState of West Virginia Employee Performance Appraisal for Transportation Crew ChiefHuman Resources
wvempperaptcs.xlswvempperaptcsState of West Virginia Employee Performance Appraisal for Transportation Crew SupervisorHuman Resources
WVOT-PR1001.pdfWVOT-PR1001Requesting a Technical Investigation of an EmployeeOffice of Technology
ZurichMileageReimbursement.pdfZurichMileageReimbursementZurich Mileage ReimbursementHuman Resources

WV DOT Privacy Notices | Contact Us | Site Map | Disclaimer
E.E.O./AFFIRMATIVE ACTION EMPLOYER

Privacy, Security and Accessibility | WV.gov | USA.gov | © 2018 State of West Virginia