Title Page
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Conducted on
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Prepared by
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Location
Vehicle Identification
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Primary driver of vehicle
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DOB
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License no. And state of issue
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Issue date
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Expiration date
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Address
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Sex
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Height
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Weight
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Eye color
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Hair color
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Organ donor
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Restrictions
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1st driver's license code
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2nd driver's license code
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ID type
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License plate No.
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Tab/decal No.
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State in which vehicle is registered
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Month and year of vehicle purchase
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Insurance company
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Photo of insurance card
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Insurance policy no.
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Insurance policy coverage
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Monthly cost
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Secondary policy (eg. AAA)
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Company the policy is through
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Policy no.
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Monthly cost
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Registration No.
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Legally registered owners
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People with authorization to enter vehicle
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Other people with authorization to drive vehicle
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Vin No.
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NICB stolen vehicle check
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NICB Total Loss/Salvage title check
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Vehicle model year
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Generation year
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Generation
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City of manufacture
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Manufacture plant
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Vehicle manufacture year
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Vehicle make
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Vehicle model
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Model family Id
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Trim package
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Cab size
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Number of doors
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Bed size
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Max payload capacity
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Vehicle color and color code
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Passenger capacity
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Overall length
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Overall width
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Overall height
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Wheelbase
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Turning circle
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Ground clearance
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Odometer reading?
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Vehicle scale weight
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Vehicle GVWR
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Max towing capacity
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Interior upholstery
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Interior trim
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Interior color
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Fuel capacity
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Fuel type
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Engine Id No.
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Engine sales code
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Engine description
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Transmission ID no.
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Transmission description
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No. Of gears
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Transmission type
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Transfer case Id no.
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Transfer case description
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Rear differential ID No.
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Rear differential description
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Front differential ID No.
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Front differential description
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Suspension description
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Options package
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Audio/video/entertainment package
Inspection
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OBD2 scan vehicle health report
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Summary of OBD2 scan vehicle health report and reported diagnostic trouble codes (DTC'S)
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Any known issues with vehicle
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Have the known issues been addressed/ being dealt with
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Vehicle drive test
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Engine condition
- Good
- Fair
- Poor
- N/A
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Vehicle handling
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Vehicle acceleration
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Vehicle braking
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Vehicle safety
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Vehicle roadworthy
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DOT Compliant
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What needs to be done to come back into compliance
Fluids
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Engine oil
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How low?
- 1/4
- 1/2
- 3/4
- 1 quart
- 1 1/2
- 2 quarts
- Unable to read
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Are there any visible leaks
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How do we fix the issue?
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Transmission fluid
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How low
- 1/4
- 1/2
- 3/4
- 1 quart
- 1 1/2
- 2 quarts
- Unable to read
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Are there any visible leaks
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How do we fix the issue?
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Transfer case
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How low?
- 1/4
- 1/2
- 3/4
- 1 quart
- 1 1/2
- 2 quarts
- Unable to read
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Are there any visible leaks
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How do we fix the issue?
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Front differential 90 weight gear oil level
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How low?
- 1/4
- 1/2
- 3/4
- 1 quart
- 1 1/2
- 2 quarts
- Unable to read
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Are there any visible leaks?
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How do we fix the issue?
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Rear differential 90 weight gear oil level
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How low?
- 1/4
- 1/2
- 3/4
- 1 quart
- 1 1/2
- 2 quarts
- Unable to read
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Are there any visible leaks?
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How do we fix the issue?
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Coolant level
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How low?
- 1/4
- 1/2
- 3/4
- 1 quart
- 1 1/2
- 2 quarts
- Unable to read
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Are there any visible leaks?
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How do we fix the issue?
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Power steering fluid level
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How low?
- 1/4
- 1/2
- 3/4
- 1 quart
- 1 1/2
- 2 quarts
- Unable to read
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Are there any visible leaks?
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How do we fix the issue?
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Brake fluid level
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How low?
- 1/4
- 1/2
- 3/4
- 1 quart
- 1 1/2
- 2 quarts
- Unable to read
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Are there any visible leaks?
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How do we fix the issue?
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Fluid levels
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Brake fluid
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Power steering fluid
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Coolant
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Oil
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Transmission
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Transfer case
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Rear differential
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Front differential
condition
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Emergency warning lights
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Safety restraint systems
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Exterior cleanliness
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Interior cleanliness
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Interior Upholstery
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Audio/video entertainment
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Heating and air conditioning
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Body
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Glass and mirrors
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Tires
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Rims
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Rear differential
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Exhaust
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Four wheel drive
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Transmission
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Lights
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Electrical
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Steering
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Brakes
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Suspension
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Engine
Final summary and evaluation
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Attached estimate for required maintenance/repairs
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What is your overall evaluation of the vehicle
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Does the vehicle need to be parked untill maintenance/repairs can be made
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Vehicles estimated value
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Kelly blue book report
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Is the vehicle in danger of breaking down
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Is the vehicle safe to operate on public roadways
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Overall condition of vehicle