Delivery Driver Daily Log Form

Delivery Driver Daily Log Form
Please complete this form to record your daily delivery activities and route details.
Section 1 – Driver Information
Driver's Full Name
First NameLast Name
Employee ID
Driver License Number
Co-Driver Name
Section 2 – Carrier Information
Motor Carrier Name
Motor Carrier Main Office Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Section 3 – Vehicle Information
Truck/Tractor Number
Trailer Number
Section 4 – Shipment Information
Shipping Document Number
Shipper Name
Commodity Description
Section 5 – Duty Status

24-Hour Duty Status Grid

Rows	Off Duty	Sleeper Berth	Driving	On Duty Not Driving	Location
12:00 AM
1:00 AM
2:00 AM
3:00 AM
4:00 AM
5:00 AM
6:00 AM
7:00 AM
8:00 AM
9:00 AM
10:00 AM
11:00 AM
12:00 PM
1:00 PM
2:00 PM
3:00 PM
4:00 PM
5:00 PM
6:00 PM
7:00 PM
8:00 PM
9:00 PM
10:00 PM
11:00 PM

Log Type
Duty Status
Section 6 – Daily Summary
Total Off-Duty Hours
Total Sleeper Berth Hours
Total Driving Hours
Total On-Duty Not Driving Hours
Total Miles Driven Today
Log Start Date & Time
MonthDayYear
Date
Hour MinutesAM/PM Option
Section 7 – Certification
Certification Statement
Driver's Signature
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Certification Date
MonthDayYear
Date
Date
MonthDayYear
Date
Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Vehicle Information (Make, Model, Plate Number)
Supervisor's Name
First NameLast Name
Shift Start Time
Hour Minutes
AM/PM Option
Shift End Time
Hour Minutes
AM/PM Option
Starting Odometer Reading (miles)
Ending Odometer Reading (miles)
If you encountered any issues or incidents, please provide details here.
Clarification on whether the form is for
Additional Comments or Notes
Were there any issues or incidents during your shift?
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