VEHICLE SELF-INSPECTION CHECKLIST

VEHICLE SELF-INSPECTION
CHECKLIST
Owner Name: __________________________________ Policy No.: ___________________
Vehicle Make: _______________ Model: _______________________ No.: _____________________
Odometer Reading: ________________ Inspector (Print Name): _________________________________

© 2012 GuideOne Risk BEFORE STARTING THE ENGINE (ENGINE IS COLD) COMMENTS
Resources for Health Care, a
Exterior (Explain any "No" responses)
division of Lutheran Trust,
Church Asset Management. No body damage, loose trim or moldings; doors lock Yes No
All rights reserved. Lights, signals, flashers, mirrors, window are in good
Yes No
condition; horn is in good working order
This material is for informational
Registration tag is current Yes No
purposes only. It is not intended
to give specific legal or risk Tire pressure and tread good; wheels in good condition;
Yes No
management advice, nor are any and spare tire properly inflated
suggested checklists or actions Under the Hood / Under the Vehicle
plans intended to include or
address all possible risk
Battery, belts, all fluid levels are good, with no signs of
Yes No
management exposures or
leaks and no loose components
solutions. Muffler, exhaust, suspension system, shock absorbers,
Yes No
drive train show no leaks, loose parts, or defects
You are encouraged Interior
to consult with your own
attorney or other expert Vehicle interior is clean; no loose objects Yes No
consultants for a Fire extinguisher, first aid kit, and warning reflectors are
Yes No
professional opinion in good condition and correctly stowed
specific to your situation.
All seat belts are secure; child safety seats are properly
Yes No
installed and not in front seat (or rear seats of vans)
Removable seats are properly secured or removed Yes No
AFTER STARTING THE ENGINE (PARKING BRAKE ENGAGED)
Normal sounds (no unusual noises) Yes No
All gauges are operating in appropriate ranges Yes No
Brake feels firm Yes No
GuideOne Risk Resources for With the brake engaged, transmission shifts through the
Health Care Yes No
selection range with no delay or unusual noises
1111 Ashworth Road
West Des Moines, Iowa 50265 Parking brake is properly adjusted VEHICLE CONDITION
Yes No
1-800-688-3628 REPORT
Heater, defroster, air conditioner operate effectively Yes No Acceptable
Steering wheel turns OK (not loose) Yes No Vehicle can be driven
without further inspection
WHILE DRIVING (COMPLETE AFTER TEST DRIVE) by a mechanic.
No unusual movement, vibration, or sounds during Needs Attention
Yes No
operation, acceleration, or braking Vehicle can be driven but
Engine runs clean (no smoke, steam, or unusual odors) Yes No should be inspected by a
Vehicle does not pull or wander while driving or braking Yes No mechanic within 30 days.
Needs Immediate
Attention
Speedometer accurate; gauges operate in normal Vehicle should NOT be
Yes No
ranges driven until inspected by a
mechanic.

Signature: _____________________________________________________________ Date: ____________

Vehicle Self-Inspection Checklist | goriskresources.com 1