🚗 Personal Vehicle Inspection

• Conducted on

  Date

• Prepared by

• Location
  Address

FRONT

• High beam right

  Safe

  At Risk

  N/A

• High beam left

  Safe

  At Risk

  N/A

• Low beam right

  Safe

  At Risk

  N/A

• Low beam left

  Safe

  At Risk

  N/A

• Turn signal right

  Safe

  At Risk

  N/A

• Turn signal left

  Safe

  At Risk

  N/A

• Hazard lights right

  Safe

  At Risk

  N/A

• Hazard lights left

  Safe

  At Risk

  N/A

• Tire conditions right

  Safe

  At Risk

  N/A

• Tire conditions left

  Safe

  At Risk

  N/A

REAR

• Tail lights right

  Safe

  At Risk

  N/A

• Tail lights left

  Safe

  At Risk

  N/A

• Brake lights right

  Safe

  At Risk

  N/A

• Brake lights left

  Safe

  At Risk

  N/A

• Brake lights center

  Safe

  At Risk

  N/A

• Hazard light right

  Safe

  At Risk

  N/A

• Hazard light left

  Safe

  At Risk

  N/A

• Turn signal right

  Safe

  At Risk

  N/A

• Turn signal left

  Safe

  At Risk

  N/A

• Tire condition right

  Safe

  At Risk

  N/A

• Tire condition left

  Safe

  At Risk

  N/A

• Backup light right

  Safe

  At Risk

  N/A

• Backup light left

  Safe

  At Risk

  N/A

MISCELLANEOUS

• Wipers

  Safe

  At Risk

  N/A

• Washer fluid

  Safe

  At Risk

  N/A

• Body condition

  Safe

  At Risk

  N/A

• Safety belts

  Safe

  At Risk

  N/A

• Horn

  Safe

  At Risk

  N/A

• Windshield glass

  Safe

  At Risk

  N/A

• Accident report kit

  Safe

  At Risk

  N/A

• Driver’s side mirror

  Safe

  At Risk

  N/A

• Rear view mirror

  Safe

  At Risk

  N/A

SIGN OFF

• By initialing this inspection, I understand this is to determine obvious visible defects. This does not take the place of an inspection by a certified mechanic. My duty and responsibility is to maintain my vehicle in good condition and safe working order.

  Sign

• By initialing this inspection, I understand this is to determine obvious visible defects. This does not take the place of an inspection by a certified mechanic. My duty and responsibility is to maintain my vehicle in good condition and safe working order.

  Sign