Fillable Printable Used Vehicle Inspection Form - Ford

Used Vehicle Inspection Form - Ford

I. INITIAL INSPECTION

ODOMETER READING

Before road test: After road test:

HOUR METER READING

(Diesel engine vehicles only)

Yes No

qqHas the current scheduled maintenance interval been

performed?

qqAre there any noticeable (non-factory) modifications* on this

vehicle? If yes, please describe:

II. EXTERIOR OF VEHICLE

Yes No

qqAre all exterior lights operational?

qqIs there any obvious exterior vehicle damage?

qqIs vehicle equipped with a snowplow?

III. UNDER HOOD

Pass Fail

qq ENGINE**– examine for leaks, obvious damage, and abnormal

noises. Oil condition and oil level are correct with no signs of

sludge.

qqAIR INLET SYSTEM– air filter, filter box, and inlet tube are

clean.

qqEMISSION SYSTEM– all components are intact and system

passes scan tool test. If diagnostic trouble codes are present,

please note them here and repair:

qqRADIATOR/COOLING SYSTEM–no leaks, obvious damage,

or wear to the water pump, overflow bottle, hoses, fan. Coolant

is in good condition and full.

qqAUTOMATIC TRANSMISSION–no leaks or obvious damage.

Fluid is in good condition and correct level.

qqPOWER STEERING–pump, gear, and hoses have no leaks or

obvious damage.

qqELECTRICAL – cables are corrosion-free, starter and alternator

are operational, and wiring harnesses are intact and without

corrosion or modifications.

qqAIR CONDITIONING–compressor, clutch, and hoses have no

leaks, obvious damage, or unusual noises.

qqBRAKE SYSTEM–no leaks or obvious damage. Fluid is at

proper level and clean.

qqELECTRIC OR HYBRID VEHICLE COMPONENTS–no

obvious damage or corrosion.

IV. UNDER VEHICLE

Pass Fail

qqTRANSMISSION OR TRANSFER CASE–no leaks, damage, or

wear.

qqHALF SHAFT AND CV JOINTS OR DRIVE SHAFT AND

U-JOINTS –no leaks, obvious damage, or wear.

qqBRAKE SYSTEM–no leaks, obvious damage, or wear.

qqSTEERING SYSTEM AND LINKAGE–no leaks, obvious

damage, or wear.

qqSUSPENSION SYSTEM–no leaks, obvious damage, or wear.

qqAXLES –no leaks, obvious damage, or wear.

qqEXHAUST SYSTEM–no leaks, obvious damage. All

components in place including convertors.

qqFRAME/UNDERCARRIAGE – examine for damage or wear.

V. VEHICLE INTERIOR CHECKS & ROAD TEST

Pass Fail

qqENGINE PERFORMANCE–no obvious problems (e.g.,

starting, poor performance, smoking, etc.).

qqTRANSMISSION PERFORMANCE–shifts smoothly with no

unusual noises.

qqBRAKE SYSTEM–vehicle brakes without any issues (e.g.,

drift, pull, noise, vibration, etc.). Parking brake functions

properly.

qq STEERING – steering is tight and responsive with no unusual

characteristics or noises.

qq SUSPENSION – vehicle exhibits no sign of harshness or loose

suspension.

qqA/C AND HEATER – operating properly with no unusual

noises.

qqVIBRATION/NOISE – No unusual vibration or noise.

qqINSTRUMENT WARNING LIGHTS – no warning lights

illuminated while operating the vehicle.

INTERIOR EQUIPMENT – items are working:

Pass Fail Pass Fail

qqWiper/Washer qqInstrument Gauges

qqPower Seats qqClimate Controls

qqLights qqHorn

qqWindows/Locks qqNavigation/Video System

qqMirrors qqMoonroof

qqClock/Audio System qqOther Switches/Controls

qqHeated Backglass

*Future failures related to a modification are subject to denial.

** Engine, transmission, and drive axle must be the same original equipment

specified for the vehicle and meet all applicable Federal Regulations to be eligible

for ESP coverage.

q Reviewed eligibility limitations to ensure vehicle is eligible for ESP coverage.

qVerified through OASIS that NVLW or specified component parts are not voided,

in whole or in part, or is not a branded vehicle (Ford, Lincoln, Mercury vehicles)

as vehicle would be ineligible for ESP.

qAttached a copy of the interim repair order, indicating repairs performed on the

vehicle prior to the sale.

Customer Name _________________________________________________________________________________________________________________________________

Customer Signature ________________________________________________________ Date ________________________________________________________________

Used Vehicle Inspection Checklist

Inspection is required on used vehicles for ESP, ESC and Royal Shield plans. Check the boxes below.

Dealer Name: P&A Code: RO Number:

Vehicle Identification Number (VIN):

12ESP-UVIC January 2012

64172_121b

NOTE:Any item with a “No” or “Fail” must be repaired, at the vehicle owner’s expense, prior to the sale of an ESP, ESC, or Royal Shield Plan. These items should also be

described below.

Comments

Technician or Inspector Signature ____________________________________________ Date ________________________________________________________________