Title Page

  • Report Number

  • Registration Number

  • VIN Number

  • Unit Description

  • Owner

  • Drivers Name and Contact Number

  • Conducted on

  • Prepared by

Vehicle Information

  • VEHICLE INFORMATION

  • Hubbometer Reading

  • Cost Recovery

  • Take a minimum of 4 photos of unit, front, rear, and both sides for reference

  • Note any unusual issues with unit. Ie. Missing spare wheels, fire extinguishers etc

  • DETAILS OF REPAIR

  • Describe details of repair requested

  • Take photos of issue

  • Expected Return date

  • Is a quote required before proceeding?

  • Drivers signature

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.