Information
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Document No.
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Conducted on
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Prepared by
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Location
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Rego
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Take a photo of your licence
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Speedo Reading
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Next Service Due (Km)
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Is the Toll tag present and serviceable?
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Is the fuel card present and serviceable?
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If unroadworthy or damaged enter details
Vehicle Operation
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Gear stick and reverse lights
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Door handles and locks
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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All instruments
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Seats
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Seat belts
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Wipers/Washer
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Head lights switch and operation
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Indicators switch and operation
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Brake Pedal and lights
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Interior Light
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Window Operation and all glass
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
Emergency Equipment
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First Aid Kit is complete and in date
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Fire Extinguisher is serviceable and current
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
Exterior
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Signage Rack
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Sides, Head Board, Tail Gate
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Body work
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Spare wheel jack & brace
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Spare wheel
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Tow bar, ball, coupling and electrics
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Tyres seem to be serviceable and legal
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Reverse Beeper
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
Under Bonnet
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Bonnet Operation
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Door handles and locks
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Coolant Level
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Engine Oil Level
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Clutch Fluid Level
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Washer Bottle Full
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Break Fluid Level
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Oil Leaks
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
Arrowboard
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Control box is secure and buttons/switches serviceable
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Arrowboard Raises
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Arrowboard lowers
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Left Arrow
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Right Arrow
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Wig Wags
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Flashing Beacons
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Oil Leaks
- Roadworthy
- Damaged but safe
- Un Roadworthy
- N/A
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Enter Details
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Signature