Title Page
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Site conducted
- Comerfords
- F and m motors
- Youngs
- Guilfoyles
- Kenneallys
- Osullivans
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REG NUMBER
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MAKE AND MODEL
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PULSE NUMBER
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DATE OF RECEIPT OF NOTIFICATION TO EXAMINE
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Conducted on
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Prepared by
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Location
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WITNESS
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YEAR OF FIRST REGISTRATION
- THREE YEARS OLD OR LESS
- GREATER THAN 3 BUT LESS THAN 8 YEARS OLD
- 8 BUT LESS THAN 10 YEARS OLD
- GREATER THAN 10 YEARS OLD
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ODOMETER READING
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FUEL TYPE
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VALID NCT
- VEHICLES FOUR YEARS OLD OR LESS
- IN DATE - MORE THAN 1 YEAR
- IN DATE - LESS THAN 1 YEAR
- NO NCT
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CONDITION OF TYRES
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GENERAL CONDITION OF VEHICLE FOR AGE AND ODO READING
- EXCELLENT - NO SCRATCHES OR DENTS
- NORMAL WEAR AND SCUFFS
- POOR - DENTS AND SCRATCHES ALL AROUND
- ACCIDENT DAMAGE
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ESTIMATED MARKET VALUE
CERTIFICATION
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I EAMON RALEIGH GARDA PSV INSPECTOR CERTIFY THAT THE CORRECT MARKING FOR THIS VEHICLE IS AS SHOWN IN THE AUDIT SECTION ON PAGE 2.
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THE VEHICLE SHOULD BE
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SIGNED EAMON RALEIGH GARDA 33739M
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DATE FORWARDED TO TOWING OFFICE
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PHOTO OF VEHICLE
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PHOTO OF STAMPED VIN NUMBER
