Vehicle Inspection Form

Facility Name*

Vehicle (Year/Make/Model)*

Mileage:*

Next Due Oil/Filter/Lube Service (Date & Mileage)*

Inspected by:*

Date:*

Accident Forms, Proof of Insurance, and Registration expiration:*

License plate tags expiration:*

Oil/filter and lube intervals recorded and on schedule:

Yes

Engine Oil Level*

Engine Oil Amount Added (N/A if none)*

Coolant Fluid Level*

Coolant Fluid Amount Added (N/A if none)*

Power Steering Fluid Level*

Power Steering Fluid Amount Added (N/A if none)*

Transmission Fluid Level*

Transmission Fluid Amount Added (N/A if none)*

Brake Fluid Level*

Brake Fluid Amount Added (N/A if none)*

Windshield Washer Fluid Level*

Windshield Washer Fluid Amount Added (N/A if none)*

Safety Belts Operational*

Windshield Glass and Wipers*

Horn Operational*

All Control Levels Operational (wipers, washer, fan, etc)*

Interior Clean & Seats in Good Condition*

Interior Dash Gauges Operational*

First Aid Kit*

Fire Extinguisher*

Snow Brush/Ice Scraper*

Comments (required regarding any marked "faulty" above)

Exterior Body Condition*

Brake - Backup - Tail Lights*

Head Lights*

Tire Pressure & Tread Depth*

Turn Signals*

Mirrors (Rearview and Side)*

Spare Tire, Jack, & Lug Wrench*

Comments (required regarding any marked "faulty" above)

Speedometer/Odometer Operational*

Brakes (Foot & Parking) Operational*

Vehicle Handling*

Comments (required regarding any marked "faulty" above)

Vehicle Safety Inspection