Full Name of Agent Checking *Submitting Date *2126212521242123212221212120211921182117211621152114211321122111211021092108210721062105210421032102210121002099209820972096209520942093209220912090208920882087208620852084208320822081208020792078207720762075207420732072207120702069206820672066206520642063206220612060205920582057205620552054205320522051205020492048204720462045204420432042204120402039203820372036203520342033203220312030202920282027202620252024202320222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719260102030405060708091011120102030405060708091011121314151617181920212223242526272829303132CURRENT MILEAGE *Natis Disc Exp Date *2126212521242123212221212120211921182117211621152114211321122111211021092108210721062105210421032102210121002099209820972096209520942093209220912090208920882087208620852084208320822081208020792078207720762075207420732072207120702069206820672066206520642063206220612060205920582057205620552054205320522051205020492048204720462045204420432042204120402039203820372036203520342033203220312030202920282027202620252024202320222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719260102030405060708091011120102030405060708091011121314151617181920212223242526272829303132Vehicle *Fortuner | LilianeFortuner | SylvainFortuner | InnaFortuner | GoldNissan Navara D/CSafaris | HiluxSafaris | IsuzuSafaris | NissanBus | HiaceBus | QuantumToyota VoxyToyota RAV4Mazda MPVVW TouranVW PoloNP300 D/CAudi A5Date of Service *2126212521242123212221212120211921182117211621152114211321122111211021092108210721062105210421032102210121002099209820972096209520942093209220912090208920882087208620852084208320822081208020792078207720762075207420732072207120702069206820672066206520642063206220612060205920582057205620552054205320522051205020492048204720462045204420432042204120402039203820372036203520342033203220312030202920282027202620252024202320222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719260102030405060708091011120102030405060708091011121314151617181920212223242526272829303132Next Service Date | Next Mealage ie: 13 December 2000 | KM 3000NTB Disc Exp Date *2126212521242123212221212120211921182117211621152114211321122111211021092108210721062105210421032102210121002099209820972096209520942093209220912090208920882087208620852084208320822081208020792078207720762075207420732072207120702069206820672066206520642063206220612060205920582057205620552054205320522051205020492048204720462045204420432042204120402039203820372036203520342033203220312030202920282027202620252024202320222021202020192018201720162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719260102030405060708091011120102030405060708091011121314151617181920212223242526272829303132Headlights *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