"Vehicle Inspection Form"

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Vehicle Inspection
Date: ____/____/______ Time: ____: ____ AM [__] PM [__]
Car Owner’s Name: _____________________________________________________________
Vehicle Make: _______________________Model: _____________________ Year: __________
Odometer Reading: ____________________
Please check any item that needs attention and then include additional details under the
comments section below.
Start the Engine and Test The Following:
Unusual Noises:
Noises
OK [__]
Needs Attention [__]
Gauges:
Fuel
OK [__]
Needs Attention [__]
OK [__]
Needs Attention [__]
Temperature
Dashboard Warning Light
OK [__]
Needs Attention [__]
Lights:
Headlights
OK [__]
Needs Attention [__]
Break Lights
OK [__]
Needs Attention [__]
Turn Signals
OK [__]
Needs Attention [__]
Hazard Lights
OK [__]
Needs Attention [__]
Other:
OK [__]
Needs Attention [__]
Windshield Wipers
OK [__]
Needs Attention [__]
Fans and Defroster
OK [__]
Needs Attention [__]
Brakes
OK [__]
Needs Attention [__]
Parking Break
OK [__]
Needs Attention [__]
Mirrors
OK [__]
Needs Attention [__]
Horn
OK [__]
Needs Attention [__]
Exhaust System
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Vehicle Inspection
Date: ____/____/______ Time: ____: ____ AM [__] PM [__]
Car Owner’s Name: _____________________________________________________________
Vehicle Make: _______________________Model: _____________________ Year: __________
Odometer Reading: ____________________
Please check any item that needs attention and then include additional details under the
comments section below.
Start the Engine and Test The Following:
Unusual Noises:
Noises
OK [__]
Needs Attention [__]
Gauges:
Fuel
OK [__]
Needs Attention [__]
OK [__]
Needs Attention [__]
Temperature
Dashboard Warning Light
OK [__]
Needs Attention [__]
Lights:
Headlights
OK [__]
Needs Attention [__]
Break Lights
OK [__]
Needs Attention [__]
Turn Signals
OK [__]
Needs Attention [__]
Hazard Lights
OK [__]
Needs Attention [__]
Other:
OK [__]
Needs Attention [__]
Windshield Wipers
OK [__]
Needs Attention [__]
Fans and Defroster
OK [__]
Needs Attention [__]
Brakes
OK [__]
Needs Attention [__]
Parking Break
OK [__]
Needs Attention [__]
Mirrors
OK [__]
Needs Attention [__]
Horn
OK [__]
Needs Attention [__]
Exhaust System
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Tires:
Proper Inflation
OK [__]
Needs Attention [__]
Adequate Tread
OK [__]
Needs Attention [__]
Spare Inflated
OK [__]
Needs Attention [__]
Leaks:
Oil
OK [__]
Needs Attention [__]
Other
OK [__]
Needs Attention [__]
Safety Equipment:
Fire Extinguisher
OK [__]
Needs Attention [__]
First Aid Kit
OK [__]
Needs Attention [__]
Flares
OK [__]
Needs Attention [__]
Spare Bulbs/Fuses
OK [__]
Needs Attention [__]
GPS
OK [__]
Needs Attention [__]
Seat Belts
OK [__]
Needs Attention [__]
Comments:
______________________________________________________________________________
______________________________________________________________________________
Condition of Vehicle Following the Inspection:
[__] Acceptable: The vehicle may be driven without further inspection.
[__] Requires Attention: The vehicle may be driven and it should be serviced in the next week.
[__] Requires Immediate Attention: The vehicle should not be driven until it has been serviced.
______________________________________________________________________________
Driver’s Signature
Date
______________________________________________________________________________
Inspector’s Signature
Date
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