Vehicle Safety Equipment Checklist Form
Complete this checklist to ensure all essential vehicle safety equipment is present and in proper working condition.
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector Name
*
First Name
Last Name
Vehicle Identification Number (VIN)
*
Headlights and Taillights Functionality
*
Pass
Fail
Not Applicable
Brake System Condition
*
Pass
Fail
Not Applicable
Tire Tread and Pressure
*
Pass
Fail
Not Applicable
Windshield Wipers and Washer Fluid
*
Pass
Fail
Not Applicable
Emergency Equipment (First Aid Kit, Fire Extinguisher, Warning Triangle)
*
Present and Functional
Missing or Incomplete
Not Applicable
Seat Belts Condition
*
Pass
Fail
Not Applicable
Additional Comments or Notes
Submit Checklist
Should be Empty: