ADDITIONAL VEHICLE DETAILS FORM
COMPANY NAME
Company Director
*
Mobile
*
Format: (000) 000-0000.
INSURANCE DETAILS
NB/You will also require the following documents on hand for uploading to our server once you have received your system log in details;
VEHCILE REGO
*
REGO EXPIRY DATE
*
/
Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
YEAR MANUFACTUR
*
MAKE / MODEL
*
CAPACITY
*
NO. AXLES
*
GCM ( if applicable)
GVM
*
TARE
*
GAWR Rear
GAWR Front
Front Axle Payload
Rear Axle Payload
Please Tick if present and working ( receipts of service/maintenance will be required)
Vehicle Base ( Suburb where vehicle is generally parked)
*
INSPECTION CARRIED OUT BY:
Please ensure you have the following documents readily available to upload into your Contractor Portal
(Print Name)
*
Signature
*
Submit
Should be Empty: