Fillable Printable Used Vehicle Inspection Form - Ford
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
q q Has the current scheduled maintenance interval been
performed?
q q Are there any noticeable (non-factory) modifications* on this
vehicle? If yes, please describe:
II. EXTERIOR OF VEHICLE
Yes No
q q Are all exterior lights operational?
q q Is there any obvious exterior vehicle damage?
q q Is vehicle equipped with a snowplow?
III. UNDER HOOD
Pass Fail
q q ENGINE** – examine for leaks, obvious damage, and abnormal
noises. Oil condition and oil level are correct with no signs of
sludge.
q q AIR INLET SYSTEM – air filter, filter box, and inlet tube are
clean.
q q EMISSION SYSTEM – all components are intact and system
passes scan tool test. If diagnostic trouble codes are present,
please note them here and repair:
q q RADIATOR/COOLING SYSTEM – no leaks, obvious damage,
or wear to the water pump, overflow bottle, hoses, fan. Coolant
is in good condition and full.
q q AUTOMATIC TRANSMISSION – no leaks or obvious damage.
Fluid is in good condition and correct level.
q q POWER STEERING – pump, gear, and hoses have no leaks or
obvious damage.
q q ELECTRICAL – cables are corrosion-free, starter and alternator
are operational, and wiring harnesses are intact and without
corrosion or modifications.
q q AIR CONDITIONING – compressor, clutch, and hoses have no
leaks, obvious damage, or unusual noises.
q q BRAKE SYSTEM – no leaks or obvious damage. Fluid is at
proper level and clean.
q q ELECTRIC OR HYBRID VEHICLE COMPONENTS – no
obvious damage or corrosion.
IV. UNDER VEHICLE
Pass Fail
q q TRANSMISSION OR TRANSFER CASE – no leaks, damage, or
wear.
q q HALF SHAFT AND CV JOINTS OR DRIVE SHAFT AND
U-JOINTS – no leaks, obvious damage, or wear.
q q BRAKE SYSTEM – no leaks, obvious damage, or wear.
q q STEERING SYSTEM AND LINKAGE – no leaks, obvious
damage, or wear.
q q SUSPENSION SYSTEM – no leaks, obvious damage, or wear.
q q AXLES – no leaks, obvious damage, or wear.
q q EXHAUST SYSTEM – no leaks, obvious damage. All
components in place including convertors.
q q FRAME/UNDERCARRIAGE – examine for damage or wear.
V. VEHICLE INTERIOR CHECKS & ROAD TEST
Pass Fail
q q ENGINE PERFORMANCE – no obvious problems (e.g.,
starting, poor performance, smoking, etc.).
q q TRANSMISSION PERFORMANCE – shifts smoothly with no
unusual noises.
q q BRAKE SYSTEM – vehicle brakes without any issues (e.g.,
drift, pull, noise, vibration, etc.). Parking brake functions
properly.
q q STEERING – steering is tight and responsive with no unusual
characteristics or noises.
q q SUSPENSION – vehicle exhibits no sign of harshness or loose
suspension.
q q A/C AND HEATER – operating properly with no unusual
noises.
q q VIBRATION/NOISE – No unusual vibration or noise.
q q INSTRUMENT WARNING LIGHTS – no warning lights
illuminated while operating the vehicle.
INTERIOR EQUIPMENT – items are working:
Pass Fail Pass Fail
q q Wiper/Washer q q Instrument Gauges
q q Power Seats q q Climate Controls
q qLights q q Horn
q q Windows/Locks q q Navigation/Video System
q q Mirrors q q Moonroof
q q Clock/Audio System q q Other Switches/Controls
q q Heated 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.
q Verified 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.
qAttached 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 ________________________________________________________________
