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You are legally required to fill in this form. Do not drive vehicle if defective

Vehicle Reg No:

Driver:

Date:

Start Mileage:

End Mileage:

Is Vehicle clean : YesNo

Weekly Vehicle check - Items to be checked by driver before and during driving: function - Damage - Cleanliness etc.

Engine oil/Water/Fuel-levels/leaksDriving controls/Steering-wear-operationBrakes-pressure-operation-leaksHorn/Wipers/Washers-Operation-ConditionKeys/Keyfobs/Driver ID FobMirrors-condition-securityWheels-condition-securityTyres-Inflation-Damage-wearExhaust-condition-visual smoke emissionBody/Load-security-protectionFirst aid kit/Asbestos KitLamps/Indicators/Stop lampsNumber plate-condition-security-illuminationBody/Guards/Wings/Spray suppression-damageLocks & security devicesFire ExtinguisherReflectors/Markers/Warning deviceBattery-Security-conditionHand free workingWindscreenAncillary equipment-reverse sensors etcSpeedometer-operationWheel nuts

Have you been stopped by VOSA/Police : YesNo

Is there a defect to report? YesNo

Defect Report - Details of any faults noted should be entered below. All faults to be notified to management directly.

I accept the the details filled in are authentic.