Loaner Vehicle Return Form
Please complete this checklist to confirm the condition and details of the returned loaner vehicle.
Borrower's Full Name
*
First Name
Last Name
Borrower's Contact Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Vehicle Identification (Make, Model, Plate or VIN)
*
Return Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Odometer Reading (Miles)
*
Fuel Level at Return
*
Full
3/4
1/2
1/4
Empty
Vehicle Cleanliness
*
Clean (interior and exterior)
Moderately clean
Needs cleaning
Any Damage or Mechanical Issues?
*
No issues observed
Minor scratches/dents
Significant damage
Mechanical issue(s)
Items Returned with Vehicle
*
Keys
Owner’s manual
Registration documents
Spare tire/tools
Other
Additional Notes or Comments
Submit Return Checklist
Should be Empty: