Vehicle Fault Report

1
Todays Date* This field is required.
Date
Month
Day
Year
12
1
2
3
4
5
6
7
8
9
10
11
12
Hour
30
00
10
20
30
40
50
Minutes
PM
AM
PM
2
VEH. MAKE/MODEL* This field is required.(vehicle or Trailer with fault)
3
Year of Vehicle* This field is required.(vehicle or Trailer with fault)
4
Are you the Driver of the Vehicle?
YES
NO
5
Your Full Name* This field is required.
6
DRIVERS LIC #* This field is required.
7
LIC STATE* This field is required.
8
Contractor/Company Name* This field is required.
Vehicle Owner
9
Contractor Phone Number
10
Detailed Decription of Fault* This field is required.
11
Upload photo Take of photo of any visible faults detected
12
Upload photo 2nd photo if required
13
Does the fault require immediate attention?* This field is required.
YES
NO
14
If the fault detected requires immediate attention then please ensure you refrain from driving and address the issue immediately. This may include calling the vehicle owner, LFT Despatch and/or a mobile service repair person.

Please DO NOT at any stage drive a motor vehicle, Truck or tow a Trailer that you believe is unsafe or may have a high risk factor.

Major faults include but are not limited to any fault detected in regards to suspension, brakes and steering.

LFT DESPATCH ( 0401 671 563)
15
Please give reason if you believe the repair can be monitored only for now?* This field is required.(Only defer a repair if it is not directly related to a safety issue or poseing a high risk )
16
When do you belive the fault should be checked again?* This field is required.(1 week / 1,000km / before next scheduled run ?)
17
Signature* This field is required.
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