ELD Malfunction Reporting Form

Form for reporting Electronic Logging Device malfunctions in accordance with FMCSA 395.34, including malfunction code, description, duration, and resolution details.

Reporter Information

• Reporter Name
• Reporter Role
• Reporter Email
• Reporter Phone

Vehicle and Device Details

• Vehicle Unit Number
• ELD Manufacturer
• ELD Device ID
• Malfunction Code
  Select the code that best matches the ELD malfunction category.

Malfunction Details

• Malfunction Start Date and Time
• Malfunction End Date and Time
  Leave blank if the malfunction is still ongoing.
• Approximate Duration (Hours)
  Enter the approximate number of hours the malfunction affected operations.
• Description of Malfunction
• Impact on Operations

Interim Recordkeeping and Resolution

• Interim Recordkeeping Used?
• Interim Recordkeeping Method
• Resolution Status
• Resolution Details
  Describe corrective actions taken, vendor support case numbers, repairs, or replacement details.
• Resolution Date

Certification and Submission

• I certify that the information provided is accurate and complete to the best of my knowledge.
• Additional Notes
  Optional comments for compliance review. Do not include unnecessary PII.