Vehicle Equipment Installation Check Status Form
Please complete this form to document the installation and inspection status of vehicle equipment.
Vehicle Information
Enter the basic details about the vehicle.
Vehicle Make and Model
*
Vehicle Year
*
Vehicle Identification Number (VIN) or License Plate
*
Equipment Installed
*
Equipment Serial Number (if applicable)
Date of Installation
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Type of Installation Performed
*
Please Select
New Installation
Replacement
Upgrade
Repair
Other
Installation Checklist
*
Rows
Completed
Not Completed
Not Applicable
Equipment securely mounted
1
2
3
Wiring properly routed and secured
4
5
6
Power connections tested
7
8
9
Functionality verified
10
11
12
Safety features checked
13
14
15
Inspection Result
*
Passed
Failed
Requires Follow-up
If any issues were found during inspection, please describe them below.
Corrective Actions Taken (if any)
Technician/Inspector Name
*
First Name
Last Name
Date and Time of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Technician/Inspector Signature
*
Submit Inspection Report
Submit Inspection Report
Should be Empty: