Employee Name:	Date:
SECTION 1 – Policy and Procedure Receipt Acknowledgement
I acknowledge receipt of the Department of Forestry’s Policy and Procedures: 8-1 Human Resources General Policies 8-9 Code of Ethics 8-11 Workplace Safety – Accident Reporting, Investigation and Prevention 5-2 Motor Vehicle Operation I understand that it is my responsibility to read and abide by these policy and procedures even if I do not agree with them. If I have any questions about the policy and procedures, I understand that I need to ask my supervisor or the director of human resources for clarification. If I refuse to sign this certificate of receipt, my supervisor will be asked to initial this form indicating that a copy has been given to me and this statement has been read to me.
SECTION 2 – Motor Vehicle Operation Acknowledgement
I understand that I must have a valid driver’s license to operate any state vehicle. I understand that I am required to immediately inform my supervisor and the director of human resources if my driver’s license is revoked, suspended or expires without being renewed.
Driver’s License Number:	License Expiration Date:
(If your driver’s license number is your social security number, please write SSN.)
SECTION 3 – Employee Signature
Employee Name (Print)	Employee Signature	Date