Vehicle Inspection Checklist
Date
*
-
Month
-
Day
Year
Date
Volunteer Driver
*
Tell me about your car (check all that apply):
*
new car
annual inspection
primary vehicle
secondary vehicle
NYS Inspection Due
*
Make
*
Model
*
Odometer
*
Year
*
Please Select
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
*If 15 years or older please make a note below.
Plate #
*
Vehicle Color
*
Please Select
Red
Orange
Yellow
Green
Blue
Purple
Black
Brown
Tan
Gold
Grey
White
County
*
Please Select
Jefferson
Lewis
St. Lawrence
Required:
Clean inside (free of trash) and outside (with exception of weather-related issues)
No harsh odors (no smoke/cigarette odor)/ animal hair
A posted NO SMOKING sing in the vehicle
All doors open/close freely
Heater /air conditioner work
Speedometer and odometer are in working order
All seats equipped with functional seat belts
All windows operate properly
All headlights, taillights, turn signals and windshield wipers are in working order
Glass is free of breakage/cracks
Horn works
Rearview/side mirrors are present and free of any breakage or cracks
Tires are free of any cuts, bubbles, exposed metal, or cracks
Spare tire is present with vehicle (optional)
Stocked with personal protective equipment for driver
Does this Vehicle Pass Inspection?
*
Please Select
PASS
FAIL
Notes
Take Photo of the License Plate
*
Take Photo of the No Smoking sign
*
Take Photo of the NYS Inspection/Registration Sticker
*
Take Photo of BACKSEAT of the vehicle to ensure cleanliness
*
Driver's signature
*
Inspector's signature
*
Date
/
Month
/
Day
Year
Date
Submit
Should be Empty: