Motor Vehicle Inspection Report
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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:
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Noises
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OK [__]
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Needs Attention [__]
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Fuel
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OK [__]
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Needs Attention [__]
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Temperature
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OK [__]
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Needs Attention [__]
|
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Dashboard Warning Light
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OK [__]
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Needs Attention [__]
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Headlights
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OK [__]
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Needs Attention [__]
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Break Lights
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OK [__]
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Needs Attention [__]
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Turn Signals
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OK [__]
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Needs Attention [__]
|
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Harzard Lights
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OK [__]
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Needs Attention [__]
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Wipers
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OK [__]
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Needs Attention [__]
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Fans
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OK [__]
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Needs Attention [__]
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Breaks
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OK [__]
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Needs Attention [__]
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Parking Break
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OK [__]
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Needs Attention [__]
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Mirrors
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OK [__]
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Needs Attention [__]
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Horn
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OK [__]
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Needs Attention [__]
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Exhaust
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OK [__]
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Needs Attention [__]
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Proper Inflation
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OK [__]
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Needs Attention [__]
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Adequate Tread
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OK [__]
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Needs Attention [__]
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Spare Inflated
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OK [__]
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Needs Attention [__]
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Oil
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OK [__]
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Needs Attention [__]
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Other
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OK [__]
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Needs Attention [__]
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Extinguisher
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OK [__]
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Needs Attention [__]
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First Aid Kit
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OK [__]
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Needs Attention [__]
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Flares
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OK [__]
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Needs Attention [__]
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Spare Bulbs
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OK [__]
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Needs Attention [__]
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GPS
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OK [__]
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Needs Attention [__]
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Seat Belts
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OK [__]
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Needs Attention [__]
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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
________________________________
Inspector's Signature
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