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CNG HA X HI CH NGHA VIT NAM

SOCIALIST REPUBLIC OF VIETNAM


c lp T do Hnh phc
Independence - Freedom - Happiness
BIN BN BN GIAO XE T
HANDING AND TAKING OVER OF VEHICLE
Cn c vo Hp ng Thu xe s / Pursuant to the Car Rental Contract
No....................................
Bn giao / Deliverer: NGUYN HOI NAM Bn nhn / Recipient: CNG TY TNHH
BC N SST VIT NAM / SST
BEARINGS VIETNAM
i din bn giao / Represented
by: ..........................
i din bn nhn/ Represented by: ng / Mr.
Giao xe ti a im / Place of Delivery: CNG Larry Brian Jones
TY TNHH BC N SST VIT NAM
in thoi / Phone
No.:..........................................
Ngy giao xe / Delivery Date: 31/07/2014
a ch / Address: 6-8 ng / Street 12,
KCN VSIP 2-A, Tn Uyn, Bnh Dng.
Cng tin hnh kim tra, nh du xc nhn cc phn t 1 n 5 v ng k vo bin
bn ny bn giao cho Bn nhn mt (01) xe nh di y / The two
parties conduct an inspection of ................................... and confirm the results of
inspection, and then sign the form:
1. Xe / Vehicle

Model xe

XE S / Number Plate

INOVA 2014 G
61A -17298
2. Tnh trng xe / Condition of Vehicle
Stt
Or. No.
1
2

Mu xe / Color
BC / Silver

Danh mc kim tra


Items for inspection
Bn ngoi xe sch s, khng try / The outside body is clean and
has no scratches.
Bn bnh xe mi / The 4 wheels are still in good condition and
look brand new.

Xc nhn
Confirmation

3. Trang b theo xe / Assessories (*)


Stt
Or.
No.
1
2
3
4
5
6
7
8

Xc nhn
Confirmation

Tn / Items
B dng c thay lp: con i, tay quay, tup m c bnh xe
Tire-changing tools: Jack, wrench, locking wheel nut remover
Mc ko xe
Tow hitch
B dng c sa cha nh
Small repair kit
B thm sn
Floor mats
Chp trc bnh xe
Axle Cap
Bnh xe d phng
Spare wheel
Gt tn thuc
Ash tray
Chp nha chn gh cui
Back chair leg caps

4. B h s xe / Set of Car Papers

H s xe cha ng k / Unregistered Files


Stt/O.
N
1
2

Tn chi tit / Items

Bn chnh / Original Bn sao / Copy

Giy Xe - Registration card


S ng kim xe
Vehicle safety compliance certification

Giy BH xe hai chiu - 2-way Insurance

Giy BH nhn s - Personnel Insurance

5. Qu tng khuyn mi / Promotion gifts (nu c / If any)

Stt/
Or.N

Tn qu tng / Items

Xc nhn
Confirmation

Danh mc kim tra / Items for Inspection

Xc nhn
Confirmation

1
2
3

Stt/
Or.N
3

Bn trong xe sch s / The inside body is clean

Khoang ng c sch s / The engine compartment is clean

Stt/
Or.N

Tn / Items

Bnh cha chy / Fire extinguisher

10

Ba thot him / Emergency Hammer

11

Chn bnh xe / Wheel chock

12

Mi thuc l / Lighter

13

Cha kha ca c kha ca t xa /


Ignition Key with a remote control

14

Kha ca khng c kha ca t xa /


Ignition Key without a remote control

15

Sch HDSD xe / Car Manual

16

Sch HDSD u CD/DVD / CD/DVD Manual

17

S Bo hnh / Guarantee Book

18

Sch An ton Toyota / Safety Manual

Xc nhn
Confirmation

i din bn giao gii thch k nhng ni dung trn. i din bn nhn nghe v
xc nhn nhng ni dung trn. / The representative from the deliverer has clearly
explained the abovementioned contents. The representative from the recipient has
carefully listened to and confirmed the abovementioned contents.
Bin bn ny c lp thnh hai (02) bn c gi tr nh nhau, mi bn gi mt (01) bn.
/ This document is made in 2 originals with the same validity; one original is kept by
each of the parties.
i din Bn Giao
Representative from the Deliverer
Recipient
(K, ghi r h tn / Signature and Full
Name)

i din Bn Nhn
Representative from the

(K, ghi r h tn / Signature and Full


Name)