MCTS 270 (12/10/2018) page 2
INSTRUCTIONS
Carrier Information
All categories self-explanatory.
Trip and Vehicle Information
VEHICLE DRIVER NAME - Driver of vehicle.
VEHICLE UNIT NUMBER (OEN) - Owner Equipment Number assigned to
the vehicle.
TRIP ORIGIN - City and state where trip began.
TRIP DESTINATION - City and state where the vehicle was unloaded/made
the final stop of the day.
Intermediate Stops
Write, in order of occurrence, the city and state of ALL stops made between
the trip origin and trip destination/the final stop of the day.
Distance And Fuel Information
DATE - Date trip began.
BEGINNING ODOMETER READING - Odometer reading at the beginning
of the trip and when entering a new jurisdiction.
JURISDICTIONS (in order traveled) - Enter each jurisdiction traveled during
the trip.
HIGHWAYS USED (in order traveled by jurisdiction) - Enter the highways
traveled in each jurisdiction.
ENDING ODOMETER READING - The odometer reading at the end of the
trip or day.
JURISDICTION DISTANCE - The total distance traveled in EACH
jurisdiction.
TOTAL DISTANCE TRAVELED - Calculate and enter the total distance
traveled during the trip or day.
Prepare an Individual Vehicle Distance and Fuel Report for each trip or day of activity. Maintain report and fuel receipts for four years.
To Calculate Total Distance Traveled: Subtract the
odometer reading taken at the beginning of the trip or day
from the odometer reading taken at the end of the trip or day.
The results must equal the sum of all of the distance traveled
in all of the jurisdictions.
Fuel Information
GALLONS PLACED IN VEHICLE - In order of occurrence, enter
the gallons of fuel placed in vehicle during the trip or day. (Include
gallons obtained from bulk storage.)
VENDOR NAME - In order of occurrence, enter the name of EACH
vendor where fuel was purchased during the trip or day. If fuel
was pulled from bulk storage, write BULK.
CITY AND STATE - City and state where the vendor or bulk
storage is located.
Total Gallons
TOTAL GALLONS of fuel placed in vehicle during the trip or day.
Distance Per Gallon (MPG)
DISTANCE PER GALLON - Calculate miles per gallon for the trip
or day and enter.
To Calculate Distance Per Gallon: Divide the Total Distance
Traveled by the Total Gallons.
DISTANCE AND FUEL SUMMARY
Summarize Individual Vehicle Distance and Fuel information for this trip in this section.
JURISDICTION DISTANCE GALS JURISDICTION DISTANCE GALS JURISDICTION DISTANCE GALS
ALABAMA (AL) MANITOBA (MB) OKLAHOMA (OK)
ALBERTA (AB) MARYLAND (MD) ONTARIO (ON)
ARIZONA (AZ)
MASSACHUSETTS
(MA)
OREGON (OR)
ARKANSAS (AR) MICHIGAN (MI) PENNSYLVANIA (PA)
BRITISH COLUMBIA
(BC)
MINNESOTA (MN)
PRINCE EDWARD
ISLAND (PE)
CALIFORNIA (CA) MISSISSIPPI (MS) QUEBEC (QC)
COLORADO (CO) MISSOURI (MO) RHODE ISLAND (RI)
CONNECTICUT
(CT)
MONTANA
(MT)
SASKATCHEWAN
(SK)
DELAWARE
(DE)
NEBRASKA
(NE)
SOUTH CAROLINA
(SC)
DIST. COLUMBIA
(DC)
NEVADA
(NV)
SOUTH DAKOTA
(SD)
FLORIDA
(FL)
NEW BRUNSWICK
(NB)
TENNESSEE
(TN)
GEORGIA
(GA)
NEWFOUNDLAND &
LABRADOR (NF)
TEXAS
(TX)
IDAHO
(ID)
NEW HAMPSHIRE
(NH)
UTAH
(UT)
ILLINOIS (IL) NEW JERSEY (NJ) VERMONT (VT)
INDIANA (IN) NEW MEXICO (NM) VIRGINIA (VA)
IOWA (IA) NEW YORK (NY) WASHINGTON (WA)
KANSAS
(KS)
NORTH CAROLINA
(NC)
WEST VIRGINIA
(WV)
KENTUCKY
(KY)
NORTH DAKOTA
(ND)
WISCONSIN
(WI)
LOUISIANA (LA) NOVA SCOTIA (NS) WYOMING (WY)
MAINE (ME) OHIO (OH)
