Post Manufacture Window Tint Inspection Report Template printable pdf download

MARYLAND AUTHORIZED INSPECTION STATIONS

POST MANUFACTURE WINDOW TINT INSPECTION REPORT

Date of Inspection: __________________________________

INSP CERT # __________________________(if applicable)

SERO #

__________________________(if applicable)

Year: ___________________________________ Make: _______________________________________________________

Model: __________________________________ VIN: ________________________________________________________

Vehicle Owner’s Name: __________________________________________________________________________________

Owner’s Address: _______________________________________________________________________________________

City, State, Zip: _________________________________________________________________________________________

Owner’s Phone # Home: _______________________Work: _________________________ Cell: ______________________

The completion of this form is required by an authorized inspection station conducting an inspection of a vehicle or the inspection of a vehicle issued a Safety

Equipment Repair Order for defect #61 TINT and the vehicle is equipped with post manufacture window tint applied to regulated window(s). The vehicle is otherwise

compliant with all other post manufacture window tinting regulations established in the Code of Maryland Regulations.

(Regulated windows are windows required to have at least 35 percent light transmittance after the application of post manufacture window tint.)

Registered inspection mechanics will place a check mark in the appropriate box(s) listed below noting all regulated windows equipped with post

manufacture window tint. Registered inspection mechanics will test with a Division approved window tint meter each regulated window equipped

with post manufacture window tinting and record the light transmittance reading obtained from the window in the appropriate location.

Left Front ________%

Right Front ________%

Left Rear ________%

Right Rear ________%

Left Wings:

Right Wings:

Front _______%

Rear _______%

Rear Glass ________%

(Check appropriate box)

PASS

The post manufacture window tinting material applied to the noted regulated windows of the above vehicle meets or exceeds the

minimum requirement of 35% light transmittance established in the Code of Maryland Regulations. The vehicle is also compliant with all other

post manufacture window tinting regulations established in the Code of Maryland Regulations.

Note to vehicle owner - Under Transportation Article, § 23-109(j), Annotated Code of Maryland, it is a violation to materially alter or change any equipment of a

vehicle for which an inspection certificate or a repair order certification has been issued. (Penalty for violation up to $500 or 6 months in jail or both)

FAIL

The application of post manufacture window tint is not in compliance with requirements in the Code of Maryland Regulations.

I certify that the above information is accurate as of the date of the inspection.

(Only valid when signed and officially stamped by an authorized registered inspection mechanic)

___________________________________________

(INSPECTION STATION STAMP)

(Signature of Registered Inspection Mechanic)

___________________________________________

(Printed Name of Registered Inspection Mechanic)

Distribution: Original – Station Copy

Copy – Owner Copy

MSP ASED 23-04 (10-11)