Bus_request

State of Maine
Department of Education
Augusta, Maine 04333-0023
                                                                                              Please select one:
                                                                                                    Original Request
                                                                                                                             Revised Request

Bus Request Instructions

REQUEST FOR APPROVAL FOR SCHOOL BUS PURCHASE OR LEASE PURCHASE

NAME OF UNIT NAME OF PERSON COMPLETING FORM
(City, Town, SAD, CSD or MVR)
TELEPHONE NO EMAIL
The school bus or buses requested below are to be included in the school budget for school year and expenditures of funds are to be made between July 1 and June 30 of that school year. MUST BE SUBMITTED NO LATER THAN NOVEMBER 25 of the fiscal year preceding purchase.

BUS REQUEST
(List Each Bus Individually)

TYPE OF REQUEST

INFORMATION ON BUS(ES) BEING REPLACED

METHOD OF PAYMENT
(Check One. Provide Term if L, LP or Note)

Bus Type*

Capacity

Lift Equip (Y/N)

Est. Cost

Addition To Fleet

Replace

Model Year

VIN # Last 4 Digits*

Capacity

Mileage As reported 6/30

Cash

Note

Lease/LP

If Lease, LP or Note Indicate # of years

Justification for Replacement of Buses:

* Description of Bus Types and participation instructions for the State of Maine School Bus Purchasing Program can be found at: http://www.maine.gov/education/const/pt033.doc

                                                                    Signed: Date
                                                                                      Superintendent of Schools

Return to: Richard J. Soules, Department of Education, School Transportation 23 State House Station, Augusta, ME 04333-0023   Phone 624-6884 Fax 624-6841

    EF-T-17 (Revised 11/2007)