Title Page
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Vehicle Registration Number
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Name
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Date
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Mileage:
Checks
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Have you got any Fuel Leaks?
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Is your Oil, Coolant & other Fluids Ok?
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What is the Problem?
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Are your Instruments & Gauges fuctional and in working order?
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What is the Problem?
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Is the Steering ok on the Vehicle
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What is the Problem?
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Are you Wipers & Washers in working order?
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What is the Problem?
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Does your horn work?
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Are your Mirrors in good condition?
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What is the Problem?
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Is your windscreen/Windows in good condition & free from any chips or cracks
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What is the Problem?
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Are your Tyres & Wheels in good condition?
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What is the Problem?
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Is your Load Secure?
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Are all your lights, indicators and reflectors in working order?
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What is the Problem?
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Are all your body panels secure and do all doors close properly?
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What is the Problem?
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Is the security & Condition of your battery ok?
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What is the Problem?
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Is your vehicle emitting excessive smoke?
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Are your brakes in good working condition?
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What is the Problem?
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Have you any other issues with the vehicle not listed above?
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What is the Problem?
Declaration
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Did you have a Defect?
- Yes
- No
- N/A
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No Defects Write "NIL"
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Who did you report your Defect(s) to?
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Driver Signature
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Who Rectified the Defect(s)?
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Signature of who rectified Defect(s)
