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Fillable Printable Form VS-1074M - Vehicle Inspection Record for Motorcycle - New York

Fillable Printable Form VS-1074M - Vehicle Inspection Record for Motorcycle - New York

Form VS-1074M - Vehicle Inspection Record for Motorcycle - New York

Form VS-1074M - Vehicle Inspection Record for Motorcycle - New York

Bureau of Consumer and Facility Services
VEHICLE INSPECTION RECORD
SAFETY MOTORCYCLE
(See instructions on other side)
1
Date
(Month/Day/Year)
2
Odometer Reading
(Indicate if
Broken or Missing)
3
Year
of
Vehicle
4
Make
of
Vehicle
5
New York State
Plate Number
*
6
Specify
What
Brake is
Inspected
789
Items Rejected
or Adjusted
(Codes from
Column 12)
Repair
Order No.
Enter serial number of
Inspection Certificate if
vehicle passes, or
“Rejected” if vehicle fails.
Inspector’s
Certification
Number
Tire
Pressure
(Not a Rej.)Codes
1. Brakes
2. Steering/
Suspension/
Frame
3. Exhaust
4. Lights/
Reflectors
5. Tires
6. Horn
7. Mirrors
101112
Facility
Name
Address - Street or Road
County
Facility
ID No.
CityZIP Code
/ /
*If the vehicle does not have a plate, or displays a “Dealer” plate, enter the vehicle identification number (VIN) instead.
If it has an out-of-state plate, enter the state and plate number.
VS-1074M (10/15)
The VS-1074M is available online at www.dmv.ny.gov.
The Vehicle Inspection Record (VS-1074M) is used to record inspections performed on and inspection certificates issued for motorcycles. It is
also used to record information about motorcycles that are rejected after inspection. When completed, the form must be kept by the facility for two
years after the last entry. The inspection station must enter the facility name, address, and facility number in the space provided on each form.
When a motorcycle is presented for inspection, you must perform a complete and thorough inspection. If the motorcycle fails because of items
that need repair, adjustment or replacement, you must notify the customer of this and request authorization before performing repairs. If the
customer authorizes repairs, complete the repairs, enter the repair order number in column 8 and the certificate number in column 9. If the
customer chooses not to have the motorcycle repaired, write “Rejected” in column 9. After repairs are completed, the inspection data should be
recorded on the VS-1074M. This includes any items that were cause for failure. These items must be noted in column 7. Any items that would
cause the motorcycle to fail if repairs were NOT made, must be recorded on the VS-1074M.
For each inspection performed, enter the following information in the appropriate numbered column:
1. enter the date of the inspection (Month/Day/Year).
2. enter the odometer reading, as it appears on the motorcycle, followed by an “M” if the reading is in miles, or a “K” if the
reading is in kilometers. If the odometer is broken or missing, write the word “Broken” or the word “Missing”.
3. enter the model year of the motorcycle, as it appears on the registration or other documents. If the year of the motorcycle is wrong,
tell the customer that it should be corrected, but do not reject the motorcycle for the wrong year.
4. enter the make of the motorcycle.
5. enter the license plate number. If the motorcycle does not have a plate, or displays a “Dealer” plate, enter the vehicle identification
number (VIN) instead. If the motorcycle has an out-of-state plate, enter the state and plate number.
6. indicate how brakes were inspected. If brake inspection was by road test, write “T” in this column. If one or more wheels were
visually inspected or pulled, indicate which one(s).
7. if the motorcycle fails inspection, list the items that failed. Use the number(s) from the code list in column 12.
8. enter the number of the repair order, if one was prepared. (If repairs are to be performed, an invoice must be prepared, and the
customers authorization must be obtained.)
9. if the motorcycle passes inspection, enter the number of the certificate (VS-1082.1) issued. If the motorcycle fails inspection, enter
the word “Rejected”.
10. from the certified inspectors card, enter the number of the certified inspector who performed the inspection.
11. check this box if tire pressure is not within specifications. Do not reject the vehicle. The motorist must be notified of the
problem.
VS-1074M (10/15)
INSTRUCTIONSFORCOMPLETINGVEHICLEINSPECTIONRECORD-SAFETYMOTORCYCLE- FORM VS-1074M
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