Vehicle Roadworthiness and Participant Safety Inspection

• Conducted on (today’s date)

  Date

• Completed by

• Role e.g CSW, TL etc.

• Location
  Address

Vehicle information

• Name of Vehicle's Driver

• License plate

  Media

• Is the vehicle due for a service? (Check sticker v Odometer)

  Yes

  No

• Is a Linkt (toll) tag present?

  Yes

  No

• Is the Disability Pass present and in date?

  Yes

  No

• Is a Fuel Card present?

  Yes

  No

• Vehicle mileage (photograph the current Odometer reading)

  Media

Exterior

• Is the exterior of the vehicle clean?

  Yes

  No

• Any damage to the bodywork of the vehicle?

  Yes

  No

• Are all required logos in place and undamaged

  Yes

  No

Interior

• Overall cleanliness

  Poor

  Fair

  Good

• Describe the state of the floor of the vehicle

  Select Clean Trash Excessive Dirt Clutter

  • Clean
  • Trash
  • Excessive Dirt
  • Clutter

• Are Childproof Locks applied on the rear doors of the vehicle?

  Yes

  No

• Is there a First Aid kit present in the vehicle?

  Yes

  No

• Inspected by

  Sign