DOT Annual Vehicle Inspection

Vehicle Record

Fleet Unit Number

Inspection Date

PDF Filename

DOT Unit MM-DD-YY.pdf

Carrier & Inspector

Motor Carrier Operator

Inspector Name

Address

City, State, ZIP

Inspector Qualified (Section 396.19)

Meets requirements

Vehicle ID Method

Lic. Plate VIN Other

Vehicle Information

Vehicle Type

Tractor Trailer Truck Other

Vehicle Components Inspected

OK = passes, N/A = not applicable, NR = needs repair. Enter repaired date when applicable.

OK	N/A	NR	Rep. Date	Inspection Item

Additional Notes

Other conditions preventing safe operation

Inspector Signature

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Annual Vehicle Inspection Report