Vehicle Receipt Form
Document the handover and receipt of a vehicle accurately and securely.
Date and Time of Receipt
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Vehicle Make
*
Vehicle Model
*
Vehicle Year
*
Vehicle Identification Number (VIN)
*
License Plate Number
*
Odometer Reading (miles or km)
*
Accessories/Items Handed Over
Keys
Registration Documents
Insurance Papers
Owner’s Manual
Spare Tire
Other
Condition of Vehicle at Receipt
Rows
Good
Fair
Poor
N/A
Exterior
1
2
3
4
Interior
5
6
7
8
Tires
9
10
11
12
Engine
13
14
15
16
Lights
17
18
19
20
Additional Notes or Comments
Name of Person Handing Over Vehicle
*
First Name
Last Name
Contact Number (Person Handing Over Vehicle)
*
Please enter a valid phone number.
Format: (000) 000-0000.
Name of Person Receiving Vehicle
*
First Name
Last Name
Contact Number (Person Receiving Vehicle)
*
Please enter a valid phone number.
Format: (000) 000-0000.
Signature of Person Handing Over Vehicle
*
Signature of Person Receiving Vehicle
*
Submit Receipt
Submit Receipt
Should be Empty: