Title Page
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Document No.
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Drivers Name
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Conducted on
General
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Vehicle Make
- Honda
- Mitsubishi
- Nissan
- Toyota
- Mazda
- Isuzu
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Model
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Vehicle Rego
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Vehicle Year
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Odometer / Hubo Reading
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RUC paid to
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Service Due At
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WOF / COF Due
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Rego Due
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Drivers License Number
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Expiry Date
Checklist
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Tyres and spare
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Why
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2. Sun Visor
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Why
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3. Mirrors / blind spots
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Why
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4. Wipers
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Why
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5. Window Washer
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Why
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6. Headlights
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Why
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Stop Lights
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Why
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8. Indicators
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Why
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9. Reversing Lights
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Why
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10. Seat Belts
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Why
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11. Handbrake
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Why
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12. Damaged Panels
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Why
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13. Doors open freely
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Why
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14. Cleanliness of Vehicle
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Why
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15. Spare Key
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Why
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16. First Aid kit
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Why
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17. Accident forms / pen
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Why
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18. Fire Extinguisher
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Why
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Fire Extinguishers K.P.A
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19. Check Oil
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Why
Finishing
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Driver Comments
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I confirm that the vehicle has not been used for private purposes this month, unless it was specifically authorised and incidental to work business only.
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Any concerns (noted above)
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Signature
