Monthly Vehicle Self-Inspection Report
Diocese of Pensacola-Tallahassee (Revised April 2025)
Please fill out ONE form per vehicle
Location and Site ID:
*
Basilica of St. Michael the Archangel 038
Blessed Sacrament 060
Blessed Trinity 004
Cathedral of the Sacred Heart 032
Catholic Charities, Fort Walton Beach 088
Catholic Charities, Panama City 080
Catholic Charities, Pensacola 081
Catholic Charities, Tallahassee 087
Christ Our Redeemer Church 046
Christ the King Church 047
Co-Cathedral of St. Thomas More 062
Corpus Christi Church 011
Fox Trace Housing 086
Good Shepherd Church 061
Holy Cross Cemetery 083
Holy Cross Church (Closed) + 2 Rentals 006
Holy Family Catholic Academy 034
Holy Name of Jesus Church 024
Holy Spirit CDA 095
Holy Spirit Church 070
Immaculate Conception Church 050
Joseph House (302 Bradford Rd) 098
Little Flower Church 030
Little Flower School 040
Mother Clelia Morningstar High School 085
Nativity of Our Lord Church 031
Our Lady of the Assumption Mission 079
Our Lady of the Rosary Church 044
Our Lady of Victory Church 009
Our Lady Queen of Martyrs Church 043
Our Lady Queen of Peace Mission 014
Pastoral Center 001
Pensacola Catholic High School 082
Resurrection Church 048
Sacred Heart Cathedral School 078
Sacred Heart of Jesus Church 017
St. Ann Church, Gulf Breeze 015
St. Ann Discovery School 041
St. Anne Church, Bellview 033
St. Anne Church, Marianna 019
St. Anthony of Padua Church 035
St. Bernadette CDA 092
St. Bernadette Church 029
St. Brendan's Retreat Center 101
St. Dominic Church 026
St. Elizabeth Ann Seton Church 008
St. Elizabeth of Hungary Mission 003
St. Eugene Chapel (FAMU) 063
St. Francis of Assisi Church 016
St. John Catholic Academy, Panama City 028
St. John Neumann Center (685 Miccosukee Rd) 060
St. John Paul II Catholic High School 066
St. John Paul II Church 166
St. John the Evangelist Church, Panama City 027
St. John the Evangelist Church, Pensacola 071
St. John the Evangelist School, Pensacola 075
St. Joseph Church, Pensacola 036
St. Joseph Church, Port St. Joe 051
St. Joseph the Worker Church 007
St. Jude Thaddeus Church 005
St. Louis Church 064
St. Margaret Church, Monticello 023
St. Margaret of Scotland Church, DeFuniak Springs 010
St. Mary Church, Fort Walton Beach 012
St. Mary Church, Pensacola 037
St. Mary School 013
St. Patrick Church 002
St. Paul Church 039
St. Paul School 042
St. Peter Church 020
St. Rita Church 057
St. Rita Pre-School 094
St. Rose of Lima Church 022
St. Stephen Church 084
St. Stephen the Protomartyr Oratory (Closed) 065
St. Sylvester Church 077
St. Theresa Church 053
St. Thomas More Church 072
St. Thomas the Apostle Church 052
St. Vincent de Paul Church 018
Sts. Peter & Paul Church 025
Trinity Catholic School 068
Trinity House (1 N C St) 001
Test Location
Year:
Please Select
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
Make:
*
Model:
*
Color:
Please Select
Beige
Black
Blue
Bronze
Gray
Green
Red
Silver
Tan
White
Yellow
License Plate:
*
Mileage:
*
Lights
Rows
Yes
No
N/A
Corrected (How?)
Corrected (When?)
Front Left – Working?
Front Right – Working?
Back Left – Working?
Back Right – Working?
High Beams – Working?
Low Beams –Working?
Hazards – Working?
Under the Hood / Under the Vehicle
Rows
Yes
No
N/A
Corrected (How?)
Corrected (When?)
Oil Level – Full?
Brake Fluid – Full?
Transmission Fluid – Full?
Washer Fluid – Full?
Battery – No signs of leaks, corrosion, or short circuits?
No leaks detected under or next to the parked vehicle?
Tires: Adequate Pressure / Even Wear / No Tread or Sidewall Problems Noted
Rows
Yes
No
N/A
Corrected (How?)
Corrected (When?)
Front Left -- OK?
Front Right -- OK?
Back Left -- OK?
Back Right -- OK?
Spare -- OK?
Safety Equipment
Rows
Yes
No
N/A
Corrected (How?)
Corrected (When?)
Windshield Wipers (including rear window) – Operating and in good condition?
Seat Belts – Operational?
Horn – Operational?
Directional Signals -- Operational?
(Optional) Fire Extinguisher – Fully charged and secured?
(Optional) First-Aid Kit – Full, contents not expired, and secured?
Tire Jack/Lug Wrench – On board and secured?
Current Diocese insurance documentation in the glovebox?
Manufacturer's Schedule for Maintenance
Rows
Yes
No
N/A
Corrected (How?)
Corrected (When?)
Records support scheduled maintenance is up-to-date?
Inspected By and Date:
*
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