Vehicle Headlight Inspection Checklist
Complete this checklist to document the condition and performance of vehicle headlights and related lamps during inspection.
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector Name
*
First Name
Last Name
Vehicle Make
*
Vehicle Model
*
Vehicle Registration/Plate Number
*
Left Headlight Condition
*
Operational
Dim
Flickering
Not Working
Right Headlight Condition
*
Operational
Dim
Flickering
Not Working
Headlight Alignment
*
Correct
Slightly Off
Significantly Off
Headlight Brightness
*
Adequate
Slightly Dim
Too Bright
Very Dim
Beam Performance
*
High and Low Beams Operational
Only Low Beam Working
Only High Beam Working
Neither Working
Related Lamps Check (Select all that apply)
Parking Lamps Operational
Indicator Lamps Operational
Fog Lamps Operational
Daytime Running Lamps Operational
Defects Observed
Broken Lens
Moisture Inside
Discoloration
Loose Fitting
Electrical Issue
Other
Corrective Action Needed
Replace Bulb
Adjust Alignment
Repair Wiring
Replace Lens
Seal Moisture
No Action Needed
Overall Inspection Result
*
Pass
Fail
Additional Comments
Submit Inspection
Should be Empty: