Year 2025
List all repairs made. Provide a receipt for any parts used.
List all brake inspections, adjustments or repairs.
Please gauge and record the tire pressure of each tire of your equipment at minimum twice a month.
Certification: I certify that all entries hereon are complete, true and that this information was compiled from individual bills and invoices from my possession, to comply with FMCSA regulation Part 396.3(b) Required records.
Enter the day of the signature (Month is automatically set to next month).
⚠️ REQUIRED: ALL RECEIPTS/INVOICES FOR ALL PARTS AND LABOR DONE BY CERTIFIED MECHANICS MUST BE ATTACHED FOR ALL WORK AND/OR REPAIRS DONE ON THE VEHICLE.
VEHICLE/BRAKE INSPECTOR QUALIFICATION FORM MUST BE ATTACHED, IF THE WORK IS PERFORMED BY THE DRIVER.
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Note: This report is due and to be delivered at your terminal the 1st of the month following the recorded maintenance month and is considered late following the 10th of that month.
Review carefully before sending.
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