VEHICLE INSPECTION
DRIVER FULL NAME SIGNATURE DATE
EMAIL ADDRESS PHONE NUMBER
VEHICLE MAKE VEHICLE MODEL VEHICLE YEAR
LICENSE PLATE# VIN#
TO BE COMPLETED BY INSPECTOR:
COMPANY INSPECTION ADDRESS
INSPECTOR NAME INSPECTOR SIGNATURE DATE
VEHICLE MILEAGE
INSPECTION POINT PASS FAIL INSPECTION POINT PASS FAIL
Headlights Foot brakes (pads/shoes thickness)
Tail lights Min. per manufacture
Turn indicator lights Right foot
Stop lights Left foot
Horn Right rear
Speedometer Left rear
Air conditioning Emergency brake (parking brake)
Doors (open, close, lock) Steering mechanism
Safety belts for driver and passengers Ball joints
Front seat adjustment Tie rods
Interior and exterior rear view mirrors Rack & pinion
Windshield wipers Bushings
Windshield (no cracks) Muffler and exhaust system
Rear window and other glass EXTERIOR
Tires, including tread depth Dents/cracks over 1 inch
Left front [ 32nd’s / in ] Paint (scrapes/chipping/bubbling)
Right front [ 32nd’s / in ]
Left rear [ 32nd’s / in ]
Right rear [ 32nd’s / in ] VEHICLE INSPECTION:
Inspector to Circle One
INTERIOR (unholstry, seats, carpet)
Cleanliness PASS FAIL
Large stains/rips/tears
Any markings on the “FAIL” side will automatically fail inspection.
Inspection certificate expires one year from inspection date.
Non-smoker (no cigarrette odor, ashes, burns)