New York > Statewide > Department Of Motor Vehicles
Vehicle Inspection Record-Safety VS-1074S - New York
| Vehicle Inspection Record-Safety Form. This is a New York form and can be used in Department Of Motor Vehicles Statewide . |
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Facility Name Address - Street or Road City Facility ID No. County ZIP Code New York State Department of Motor Vehicles Bureau of Consumer and Facility Services VEHICLE INSPECTION RECORD-SAFETY (See instructions on Page 2) 7 8 9 10 Safety Rejection-- Check System Rejected 11 Air Bag Lights Tires Susp. Steering Other 1 2 3 4 Make of Vehicle 5 6 Specify What Wheel is Pulled 12 Tire Pressure Year________ (Month/Day) Odometer Year Reading of (Indicate if Broken, Missing or Trailer) Vehicle New York State Plate Number * Repair Order No. Enter: serial number of Inspection Certificate Inspector's if vehicle passes; Certification Enter: "Rejected" if Number Brakes vehicle fails Not a Reject Not a Reject / VS-1074S (4/12) *If the vehicle does not have a plate, or displays a "Dealer" plate, enter the VIN. If an out-of state plate, enter the state and plate number. American LegalNet, Inc. www.FormsWorkFlow.com PAGE 1 OF 2 reset/clear INSTRUCTIONS FOR COMPLETING VEHICLE INSPECTION RECORD-SAFETY - FORM VS-1074S The Vehicle Inspection Record (VS-1074S) is used to record inspections performed and inspection certificates issued. It is also used to record information about vehicles that are rejected after inspection. When completed, the form must be kept by the facility for two years after the last entry. The inspection station must enter the facility name, address and facility number in the space provided on each form. Use the VS-1074S to record ONLY Safety inspections and certificates. Motorcycle inspections and certificates must be recorded on a VS-1074M; heavy vehicle and safety/diesel inspections and certificates must be recorded on a VS-1074SD. Be sure to use the correct form for the type of inspection and certificate you are recording, and to issue and record certificates in consecutive order. If you have a NYVIP CVIS - Do not use this form. All inspection records must be maintained on the NYVIP CVIS. When a vehicle is presented for inspection, you must perform a complete and thorough inspection. If the vehicle fails because of items that need repair, adjustment or replacement, you must notify the customer of this and request authorization before performing repairs. If the customer authorizes the repairs, complete the repairs, enter the repair order number in column 7 and the certificate number in column 8. If the customer chooses not to have the vehicle repaired, write "Rejected" in column 8. After repairs are completed, the inspection data should be recorded on the VS-1074S. This includes any items that were cause for failure. These items must be checked in column 10; any notification items should be checked in columns 11 and 12. Any items that would cause the vehicle to fail if repairs were NOT made, must be checked on the VS-1074S. For each inspection performed, enter the following information in the appropriate numbered column: 1. Enter the year of the inspection at the top of the column; then enter the date of the inspection (Month/Day). 2. Enter the odometer reading, as it appears on the vehicle. If the odometer is broken or missing, or if the vehicle is a trailer, enter broken, missing or trailer. 3. Enter the model year of the vehicle, as it appears on the registration or other documents. If the year of the vehicle is wrong, tell the customer that it should be corrected, but do not reject the vehicle for the wrong year. 4. Enter the make of the vehicle. 5. Enter the license plate number. If the vehicle does not have a plate, or displays a "Dealer" plate, enter the Vehicle Identification Number (VIN) instead. If the vehicle has an out-of-state plate, enter the state and plate number. 6. Identify which wheel was pulled for brake inspection. If more than one wheel was pulled, indicate which ones (RF, LF, RR, LR). 7. Enter the number of the repair order, if one was prepared. (If repairs are to be performed, an invoice must be prepared and the customer's authorization must be obtained.) 8. If the vehicle passes inspection, enter the number of the certificate issued. If the vehicle fails inspection, enter the word "Rejected". 9. From the certified inspector's card, enter the number of the certified inspector who performed the inspection. 10. If the vehicle fails the safety inspection, check the proper box(es) for the failed item(s). 11. Check the box if there is a malfunction of the Air Bag Readiness Light (1998 and newer model year vehicles). This is not a rejection. The motorist must be notified of the problem, in writing. 12. Check this box if tire pressure is not within specifications. Do not reject the vehicle. The motorist must be notified of the problem. VS-1074S (4/12) PAGE 2 OF 2 American LegalNet, Inc. www.FormsWorkFlow.com
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