Title Page

  • Dealer Name

  • Technician Name/No:

  • RO Number (If available)

  • Rego No (If available)

  • CUSTOMER / COMPANY NAME

  • DRIVER NAME & CONTACT:

  • During hours / After hours

  • Payment Terms

Breakdown/Offsite Detail Form

TRIP INFO

  • CALL TIME:

  • START LOCATION (Location / Postcode)
  • Service Vehicle Start Km’s:

  • TIME ON SITE:

  • LOCATION OF BREAKDOWN:
  • TIME FINISH ON SITE:

  • FINISH LOCATION (Location / Postcode)
  • Service Vehicle End Km’s:

  • TIME HOME:

Vehicle Info:

  • MAKE & MODEL:

  • VIN:

  • Odometer:

  • Customer Signature

Job Story

  • Complaint - (What is the failing function?)

  • Cause - (Include diagnoses to find the cause)

  • Correction - (State how it was rectified)

  • PARTS USED & NOTES:

  • Repair (Type)

  • Tow Provider

  • Provide details of requirements / arrangements for full repair to be completed

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.