Maintenance Form Vehicle Information All fields are required.Date* Tractor Number*Owner's Name*Address*Make*Model*Year*Serial Number*Tire Size*Maintenance Checklist All fields are required.All Lights and Wiring:*SelectWithout DefectNeeds RepairsReflectors:*SelectWithout DefectNeeds RepairsWindshield Wipers:*SelectWithout DefectNeeds RepairsHorn:*SelectWithout DefectNeeds RepairsAll Mirrors:*SelectWithout DefectNeeds RepairsWarning Devices:*SelectWithout DefectNeeds RepairsSteering:*SelectWithout DefectNeeds RepairsBrakes:*SelectWithout DefectNeeds RepairsWheels, Lugs, and Tires:*SelectWithout DefectNeeds RepairsAll Leaks:*SelectWithout DefectNeeds RepairsAnnual Inspection:*SelectWithout DefectNeeds RepairsAll Engine Belts:*SelectWithout DefectNeeds RepairsCoolant:*SelectWithout DefectNeeds RepairsEngine Oil:*SelectWithout DefectNeeds RepairsCoupling Devices:*SelectWithout DefectNeeds RepairsFrame:*SelectWithout DefectNeeds RepairsSpare Fuses:*SelectWithout DefectNeeds RepairsReflector/Flare Kit:*SelectWithout DefectNeeds RepairsFire Extinguisher:*SelectWithout DefectNeeds RepairsSeat Belts:*SelectWithout DefectNeeds RepairsWindshield:*SelectWithout DefectNeeds RepairsGeneral Condition:*SelectWithout DefectNeeds RepairsMaintenance Records For Compliance with DOT regulations, part 396-inspection, repair and maintenance, the maintaining of a record on each vehicle under a service agreement for 30 days of more must include the date and nature of all repairs and lubrications as set forth in part-396. Each contractor must forward this form to the company for each month by the 10th of the following month.Date MileageRepair/Maintenance DoneClosing Details Mileage Reading*Required Information*SelectOdometerHubBy entering my name below, I provide my digital signature and affirm that the above information is true and accurate to the best of my knowledge.Owner/Operator Signature*Date Captcha
