Automotive Risk Assessment Checklist
Complete this checklist to assess and document key risk factors for the vehicle under inspection.
Assessor Full Name
*
First Name
Last Name
Assessor Email Address
*
example@example.com
Assessment Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Vehicle Identification Number (VIN)
*
Vehicle Make and Model
*
Vehicle Year
*
Automotive Risk Factor Assessment
*
Rows
Excellent
Good
Fair
Poor
Brakes
1
2
3
4
Tires and Wheels
5
6
7
8
Lights and Signals
9
10
11
12
Steering and Suspension
13
14
15
16
Safety Features (Airbags, ABS, etc.)
17
18
19
20
Engine and Transmission
21
22
23
24
Body Condition
25
26
27
28
Fluid Levels and Leaks
29
30
31
32
Are all required documents present and valid?
*
Registration Certificate
Insurance Policy
Emissions Test Certificate
Inspection Report
Other (please specify)
Has the vehicle been involved in any previous accidents or incidents?
*
Yes
No
Please provide details if any previous accidents or incidents were reported.
Overall Risk Rating for This Vehicle
*
1
2
3
4
5
Additional Comments or Recommendations
Submit Assessment
Should be Empty: