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Vehicle Inspection Form

This document is a vehicle inspection form that collects driver and vehicle information, including details about the vehicle's make, model, and inspection results. A mechanic must complete the inspection items, indicating whether each item passes or fails, and provide additional notes if necessary. The form also requires the mechanic's information and signature to validate the inspection.

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Luis Larco
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30 views1 page

Vehicle Inspection Form

This document is a vehicle inspection form that collects driver and vehicle information, including details about the vehicle's make, model, and inspection results. A mechanic must complete the inspection items, indicating whether each item passes or fails, and provide additional notes if necessary. The form also requires the mechanic's information and signature to validate the inspection.

Uploaded by

Luis Larco
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Vehicle Inspection

DRIVER INFO
Name: Applicant Existing CareDriver

Email: Phone #:

VEHICLE INFO (To be completed by mechanic)


Vehicle Make: Vehicle Model: Mileage:

Vehicle Color: Vehicle Year: # of Doors:

VIN (last 5 digits): License Plate #: License Plate State:

INSPECTION ITEMS (To be completed by mechanic - all items must pass for an overall “Pass” result)
Foot brakes Pass Fail Speedometer Pass Fail

Emergency brakes Pass Fail Horn Pass Fail

Front seat adjustment mechanism Pass Fail Muffler and exhaust system Pass Fail

Rear window & other glass Pass Fail Interior and exterior rear view mirrors Pass Fail

Steering mechanism Pass Fail Doors Pass Fail

Headlights Pass Fail Bumper Pass Fail

Tail lights Pass Fail Safety belts for driver & passengers Pass Fail

Stop lights Pass Fail Windshield wipers Pass Fail

Turn indicator lights Pass Fail Body damage (larger than a credit card) Yes No

Windshield Pass Fail Tires condition Pass Fail


Chip/small crack (Suggest repair) Depth (4/32” minimum required):
Crack in driver’s view (Fail) Right Front ______ Right Rear ______
Left Front ______ Left Rear ______

Inspection date: / / INSPECTION RESULT: Pass Fail

MECHANIC INFO (Company listed below is licensed by the Bureau of Automotive Repair)
Name: Signature:

Company: Phone Number:

Additional inspection notes:

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