Two forms in one file. Form A is a driver's promise not to tamper with the tracker or camera. Form B records a violation from the IVMS report and what was agreed.
Employment, privacy and evidence rules differ by country and employer. Ask your legal adviser to review these forms. The forms set no penalty: where a breach is mentioned, they point to your own company policy. The template does not say that any law or standard is met.
A cover page, Form A, Form B, a register of signed forms and notes for your legal adviser. About six pages.
Before a driver starts
After the talk
Open the IVMS report or the clip with the driver. Fill Parts 1 and 2 of Form B from it.
Ask what happened. Write the driver's account in the driver's words.
Tick only actions your policy allows. Set a follow-up date.
Both sign. The driver keeps a copy. Add a line to the register in Annex 1.
Form A is short and plain. The driver confirms three things.
A breach is dealt with under the company policy named on the form. The form sets no penalty. The driver may ask questions, receives a copy and may add a comment.
Form B starts from the data. Parts 1 and 2 copy the recorded event from the IVMS report: type, date and time, place, the value recorded, the limit that applies, the report or clip reference, and whether this is the first time or a repeat.
Part 3 holds the driver's account. Part 4 lists the agreed action: a talk, a coaching session, refresher training, a written reminder under your policy, a follow-up review. Part 5 is the undertaking itself:
I have seen the data about the event in Part 2 and I discussed it with my supervisor. I undertake to drive within the company rules and the limits set for my vehicle, and to follow the actions agreed in Part 4.
The driver then ticks I agree with the record, or I do not agree and adds a comment. The signature confirms that the event was discussed and a copy was received. It is not an admission.
Form A asks you to write the alarm names your platform shows for tampering. These are examples. Which events your units raise depends on the device and its settings. Ask your Tracom contact.
| Event | Name in your platform |
|---|---|
| Main power disconnected | Write the alarm name |
| Device or antenna disconnected, or satellite signal lost | Write the alarm name |
| Camera covered, blocked or turned away | Write the alarm name |
| Camera or recorder disconnected | Write the alarm name |
| SIM card or memory card removed | Write the alarm name |
| Device moved or opened | Write the alarm name |
Examples only. Write the names your platform shows.
Annex 2 lists the questions to settle before you use the forms: the language the driver reads, whether a driver may be asked to sign and what a refusal means, which steps your own policy allows, witnesses, what may be recorded and for how long, whether the privacy notice matches Form A, clip handling, and how disputes are handled.
It records what was agreed. It does not decide whether a driver broke a rule, and it is not legal advice. A form cannot replace a clear policy, a fair talk and a device that works.
Tracom devices are built with tamper-proof security. Ask us which tamper events your units raise, so Form A names the alarms your supervisors will actually see.
Need a tamper alarm list for your units? Talk to Tracom.
No. They point to your own company policy by name and number. Do not copy a penalty into the form unless your policy contains it.
That depends on your country, the employment contract and how the form is used. Ask your legal adviser. This template does not say that any law is met.
The form has a space for a witness or HR. Whether one is needed depends on your policy and local rules.
Form B lets the driver tick that they do not agree and write a comment. Decide in your policy what happens next, for example a second review of the clip.
Yes. The file is editable Word, in English and Arabic. If your drivers read another language, have a translation checked.
Tracom makes the devices. The forms are a neutral drafting aid. Tracom does not review your policy or your decisions.
Bring your IVMS report. We will show you how events reach your supervisors.
Copyright © 2026 SAFEE
