Full Name of Agent Checking *Submitting Date *2125212421232122212121202119211821172116211521142113211221112110210921082107210621052104210321022101210020992098209720962095209420932092209120902089208820872086208520842083208220812080207920782077207620752074207320722071207020692068206720662065206420632062206120602059205820572056205520542053205220512050204920482047204620452044204320422041204020392038203720362035203420332032203120302029202820272026202520242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619250102030405060708091011120102030405060708091011121314151617181920212223242526272829303132CURRENT MILEAGE *Natis Disc Exp Date *2125212421232122212121202119211821172116211521142113211221112110210921082107210621052104210321022101210020992098209720962095209420932092209120902089208820872086208520842083208220812080207920782077207620752074207320722071207020692068206720662065206420632062206120602059205820572056205520542053205220512050204920482047204620452044204320422041204020392038203720362035203420332032203120302029202820272026202520242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619250102030405060708091011120102030405060708091011121314151617181920212223242526272829303132Vehicle *Fortuner | LilianeFortuner | SylvainFortuner | InnaFortuner | GoldNissan Navara D/CSafaris | HiluxSafaris | IsuzuSafaris | NissanBus | HiaceBus | QuantumToyota VoxyToyota RAV4Mazda MPVVW TouranVW PoloNP300 D/CAudi A5Date of Service *2125212421232122212121202119211821172116211521142113211221112110210921082107210621052104210321022101210020992098209720962095209420932092209120902089208820872086208520842083208220812080207920782077207620752074207320722071207020692068206720662065206420632062206120602059205820572056205520542053205220512050204920482047204620452044204320422041204020392038203720362035203420332032203120302029202820272026202520242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619250102030405060708091011120102030405060708091011121314151617181920212223242526272829303132Next Service Date | Next Mealage ie: 13 December 2000 | KM 3000NTB Disc Exp Date *2125212421232122212121202119211821172116211521142113211221112110210921082107210621052104210321022101210020992098209720962095209420932092209120902089208820872086208520842083208220812080207920782077207620752074207320722071207020692068206720662065206420632062206120602059205820572056205520542053205220512050204920482047204620452044204320422041204020392038203720362035203420332032203120302029202820272026202520242023202220212020201920182017201620152014201320122011201020092008200720062005200420032002200120001999199819971996199519941993199219911990198919881987198619851984198319821981198019791978197719761975197419731972197119701969196819671966196519641963196219611960195919581957195619551954195319521951195019491948194719461945194419431942194119401939193819371936193519341933193219311930192919281927192619250102030405060708091011120102030405060708091011121314151617181920212223242526272829303132Headlights *License plate lights *Tyre Condition & Pressure *Tyre Size and Brand *Doors & locks: open/close smoothly *Taillights *Trailer lights if connected *Tread depth of Tire *Warning Lights *Mirrors: intact, properly adjusted *Brake lights *Wiper blades *Suspension *Air conditioning/heating systems *Wheel alignment & balance *Turn signals *Washer fluid levels *Shocks and Struts *Indicators *Brake lines & fuel lines: no leaks/damage *Engine Oil Level *Power steering fluid *Windshield washer fluid *Air Filter *Spark Plugs *Water Level and Coolant *Battery for corrosion *Check for leaks (oil, coolant, fuel) *Transmission fluid *Oil Filter *Battery number *Aircon Filter *Brake fluid *Fuel Filter *Secure connections for battery *Exhaust system: no damage or excessive rust *Brake pads/shoes condition *Steering and Alignment *Parking brake function *Raccoon Pinion *Wheel Stabilisation *Brake pedal response *Ball Joint *Proper voltage of battery *Brake discs/drums condition *Belts and Hoses *Transmission – smooth gear shifts *Suspension performance *Engine start: smooth, no unusual noises *Steering: responsive, no vibration *Gearbox Oil *Interior + Exterior + Under body Wash *Acceleration response *Suspension: absorbs bumps properly *Braking performance *Engine Cleaner *Gear shifting (manual/auto) *Recovery gear (jack, wheel spanner, tow rope, shovel) *Handling *Car Mats *Brake performance: smooth, no pull or noise *Upload Driver Side Drop your file here or click here to upload You can upload up to 1 files. Upload Battery Details Drop your file here or click here to upload You can upload up to 1 files. Upload Passenger Side Drop your file here or click here to upload You can upload up to 1 files. Upload Engine Drop your file here or click here to upload You can upload up to 1 files. Upload Front Side Drop your file here or click here to upload You can upload up to 1 files. Upload Under Carriage Drop your file here or click here to upload You can upload up to 1 files. Upload Rear Side Drop your file here or click here to upload You can upload up to 1 files. Upload Dashboard ON Drop your file here or click here to upload You can upload up to 1 files. All over Observation *Declaration and consent *I certify the above information is accurate and complete.WebsiteSubmit