Guideline Vehicle Safety Inspection Checklist Template
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1
2Guideline Vehicle Safety Inspection Checklist
Pre 1949 vehicles only
Please complete the white sections of this form and sign below. Please print clearly in ink using BLOCK letters.
Owner / Vehicle details
Surname
First given name
Second given name
Home address
Postcode
Email
Contact phone no. (mobile preferred)
Club membership no. (if applicable)
Make
Model
Year
Chassis no.
Body type
Colour
Engine no.
Yes
No Is the vehicle a replica? If yes, when was the vehicle manufactured
Year
Yes
No Has the vehicle ever been registered for road use in Australia? If yes, please provide registration number if known.
Registration no. (optional)
Note:
The following checklist is based on, and assumes the Club Scrutineer (nominated Safety Check officer) has a working understanding of, Victoria’s Standards for Registration
and any relevant VicRoads VSIs in particular:
VSI 8
Guidelines for Modification
VSI 26 Roadworthiness Requirements
VSI 33 Guidelines for Modifications to Vehicles operated under Victoria’s Club Permit Scheme
VSI checklist
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Pass
Fail N/A Not applicable
1. Wheels and tyres
Cracks/damage
Ride height
Drums
3.2 Hydraulic brakes
Studs/nuts
Bump stops, Lock stops
Piping/unions/free of leaks
Rim size/Tyre size – O/E option or to VSI 33
Travel and clearance
Master cylinder
Tread depth
3. Brakes
Wheel cylinders
3.1 Mechanical brakes
Track width
Linkages
Drums
2. Steering and suspension
Cables
Linings
Wear/play in joints and bushes
Pivots, clevis yokes, pins
Parking/secondary brake
Cracks/damage/distortion
Linings
Shock absorbers
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Parent category: Life