Title Page
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Report Number
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Registration Number
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VIN Number
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Unit Description
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Owner
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Drivers Name and Contact Number
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Conducted on
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Prepared by
Vehicle Information
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VEHICLE INFORMATION
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Hubbometer Reading
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Cost Recovery
- Customer Cost
- Warranty
- Internal Cost
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Take a minimum of 4 photos of unit, front, rear, and both sides for reference
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Note any unusual issues with unit. Ie. Missing spare wheels, fire extinguishers etc
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DETAILS OF REPAIR
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Describe details of repair requested
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Take photos of issue
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Expected Return date
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Is a quote required before proceeding?
- Yes
- No
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Drivers signature