Warrant of Fitness Inspection Checksheet

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1 Warrant of Fitness Inspection Checksheet Printed by the Motor Trade Association for members involved in the inspection of motor vehicles for a Warrant of Fitness Suitable for motorcycles and trailers DATE FROM CHECKSHEET NUMBERS FROM RECORDS: TO TO

2 WARRANT OF FITNESS CHECKSHEET GUIDELINES - MOTORCYCLES AND TRAILERS RESPONSIBILITIES Refer to your NZ Transport Agency contract Agreement for the issue of Warrants of Fitness and Performance Review System Manual REQUIRED INFORMATION - Current NZ Transport Agency Vehicle Inspection Requirements Manual. CHECKSHEET DETAIL IO and number Customer detail box Reg. No. Chassis/N No. (Motorcycles only) Year/ Make Inspecting Organisation name, address and authority number issued by NZ Transport Agency. Customer s/vehicle owners name, address and telephone number. Registration plate number. Chassis/frame number or vehicle identification number (N) as applicable. Ns have 17 characters. Year of manufacture and make, for example 2003 Suzuki, 2002 Voyager. (This information is on the vehicle license label and should match the vehicle) Model Model, for example GN 250. Date 1st Reg. NZ Current (Motorcycles only) Inspection date signature Vehicle ed Failed number Fee Expiry (28 days) date Recheck pass date New expiry date Entered Online Online number label number Inspection Items Date of first registration in New Zealand. This date is on the vehicle license label. Expiry date of the on the vehicle when it arrives for a new reading. Miles/kilometres - cross out the one that does not apply. A second odometer box is included alongside the Recheck Date to record the reading on a subsequent recheck. Date of initial inspection. Signature of the Vehicle Inspector who completed the initial inspection and, if the vehicle fails, the signature of the inspector who carried out a subsequent pass recheck. (If the vehicle fails a recheck refer Recheck pass date below) Tick ed if the vehicle passes the initial inspection or cross Failed if the vehicle fails the initial inspection. Vehicle Inspector number issued by NZ Transport Agency. If the vehicle failed the initial inspection add the fee expiry date. (Initial inspection date plus 28 days) Date the vehicle passes the inspection after initially failing. (If the vehicle fails a re-check note this and the date in the section). Note: Rechecks must take place within 28 days of initial inspection. After this time a new inspection must be carried out and a new fee charged Expiry date of the Warrant of Fitness issued, ie 6 or 12 months after the day the vehicle passes the inspection, plus up to 14 days of the unexpired portion of the previous. Tick when the check detail has been entered online. provided by Online at the completion of entering a passed inspection. Copy this onto the label and checksheet. (If the has to be completed offline, due to a system failure, write the checksheet number onto the label. Add the Online number to your copy of this checksheet when the details are entered Online) sticker on the new label affixed to the vehicle. For check detail refer to the Mandatory and Recommended Information listed above. Each check must be individually failed = cross (F), passed = tick (P) or marked not applicable = line through (F) (P) as each item is inspected. NOTE: - The number required under the heading Modified vehicle Decl/Plate is on the low volume vehicle certification plate or declaration form number where written on the form. - The tyre tread depths are required to be recorded in millimetres in the appropriate boxes under the heading Tyres. Reasons for rejection Reasons for rejection- List reasons why the vehicle was rejected its Warrant of Fitness inspection. Use the Alpha numeric code to reduce writing. Example write B1 LH Not Operating not Left hand forward position lamp not operating. During the re-check use the tyre recheck boxes in the reasons for rejection section if these are applicable. NOTE THAT WHEN YOU ISSUE THE WOF THE VEHICLE MUST MEET ALL WOF STANDARDS. Tick the box alongside the reason for rejection when an item initially rejected has been repaired and now passes inspection Comment on any matter influencing your decision during the inspection, repair carried out by you to enable the vehicle to pass the inspection, safety items not covered by legislation but noted during the inspection or failed rechecks. GST Receipt Checksheet copies Use as required. Note if the checksheet is used as a receipt it will need to be kept for seven years as a financial record. Give the top copy to the vehicle owner. The bottom copy to be retained by the Inspecting Organisation for 12 months minimum. (7 years if also used as a receipt)

3 NEED REPAIRS? Always look for the MTA sign IO This checksheet does not constitute a Warrant of Fitness It should be read in conjunction with the Consumer Information overleaf. IO = Inspecting Organisation = Vehicle Inspector Customer, s Address Phone Reg. No Year/ Make Inspection Date No. Recheck Date New MOTORCYCLES (A) DETAILS A1 Chassis/N No Yes A2 Modified Vehicle Decl/Plate X (B) FRONT LAMPS B1 Forward Position Lamps B2 Direction Indicator Lamps B3 Headlamp Condition/Aim B4 Front Fog Lamps B5 Other Lamps (C) REAR LAMPS C1 Rearward Position Lamps C2 Direction Indicator Lamps C3 Stop Lamps C4 Rear Reflectors C5 Registration Plate Lamps C6 Rear Fog Lamps C7 Other Lamps (D) STEERING SYSTEM Entered Online Reasons for Rejection D1 Hubs & Axles D2 Steering Mechanism D3 Suspension Mechanism D4 Tyre & Wheel Condition Front Side Rear (Tread Depth in mm) E1 Brake, Hoses & Components E2 Mudguards E3 Towing Connections E4 External Projections E5 Dimensions (F) PROTECTION - SION F1 Seats and Seat Anchorages F2 Footrests F3 Interior Impact F4 Doors and Hinges F5 Head Restraints F6 Glazing F7 Sunvisor F8 Wash/Wipe Motorcycles continued at the top of the right column = Item Failed = Item ed = Not Applicable Model Front Rear Signature Tax Invoice Chassis/N No. Online No. Side (Tread Depth in mm) Signature Date 1st Reg.NZ Tyre Recheck LF RF (If applicable) LR RR GST. No. Amount Paid: Cash Card/ Cheque Charge Eftpos Date: Current It is the owner, s responsibility to maintain the vehicle in warrantable condition. NZ Transport Agency reserves the right to recheck any vehicle following an inspection. Rechecks must take place within 28 days of the original inspection. After this time a new inspection must be carried out and a new fee paid. Vehicle If vehicle failed, fee expiry (28 Days) date (tick) No. Label No. FAILED PASSED (G) ROAD TEST Service Brake Performance G1 Park Brake Performance G2 ABS Self Check G3 Speedometer G4 Horn/Audible Warning Device G5 Rear View Mirrors G6 Exhaust G7 Visible Smoke G8 (H) SYSTEMS AND COMPONENTS Vehicle Structure H1 Fuel System Safe H2 Engine/Drivetrain H3 TRAILERS (A) FRONT LAMPS Forward Position Lamps A1 Other Lamps A2 (B) REAR LAMPS Rearward Position Lamps B1 Direction Indicator Lamps B2 Stop Lamps B3 Rear Reflectors B4 Registration Plate Lamps B5 Other Lamps B6 (C) STEERING SYSTEMS Hubs & Axles C1 Steering Mechanism C2 Suspension C3 Tyre & Wheel Condition C4 (Tread LF RF Depth in mm) LR RR (D) BRAKES If fitted - Rqd >2000KG Brake, Hoses & Components D1 Service Brake Performance D2 Breakaway Brakes D3 Parking Brake (>2500kg) D4 Mudguards E1 External Projections E2 Glazing E3 Drawbar/Towing Connections E4 Safety Chain (where rqd) E5 (F) SYSTEMS AND COMPONENTS Vehicle Structure F1 Copyright MOTOR TRADE ASSOCIATION (INC.) RE-ORDER REF 220M Version 10/14 Copyright - This form may not be copied or duplicated without written permission from the MTA

4 NEED REPAIRS? Always look for the MTA sign IO This checksheet does not constitute a Warrant of Fitness It should be read in conjunction with the Consumer Information overleaf. IO = Inspecting Organisation = Vehicle Inspector Customer, s Address Phone Reg. No Year/ Make Inspection Date No. Recheck Date New MOTORCYCLES (A) DETAILS A1 Chassis/N No Yes A2 Modified Vehicle Decl/Plate (B) FRONT LAMPS B1 Forward Position Lamps B2 Direction Indicator Lamps B3 Headlamp Condition/Aim B4 Front Fog Lamps B5 Other Lamps (C) REAR LAMPS C1 Rearward Position Lamps C2 Direction Indicator Lamps C3 Stop Lamps C4 Rear Reflectors C5 Registration Plate Lamps C6 Rear Fog Lamps C7 Other Lamps (D) STEERING SYSTEM D1 Hubs & Axles D2 Steering Mechanism D3 Suspension Mechanism D4 Tyre & Wheel Condition X Reasons for Rejection Front Side Rear (Tread Depth in mm) E1 Brake, Hoses & Components E2 Mudguards E3 Towing Connections E4 External Projections E5 Dimensions (F) PROTECTION - SION F1 Seats and Seat Anchorages F2 Footrests F3 Interior Impact F4 Doors and Hinges F5 Head Restraints F6 Glazing F7 Sunvisor F8 Wash/Wipe Motorcycles continued at the top of the right column = Item Failed = Item ed = Not Applicable Entered Online Model Front Rear Signature Tax Invoice Chassis/N No. Online No. Side (Tread Depth in mm) Signature Date 1st Reg.NZ Tyre Recheck LF RF (If applicable) LR RR GST. No. Amount Paid: Cash Card/ Cheque Charge Eftpos Date: Current It is the owner, s responsibility to maintain the vehicle in warrantable condition. NZ Transport Agency reserves the right to recheck any vehicle following an inspection. Rechecks must take place within 28 days of the original inspection. After this time a new inspection must be carried out and a new fee paid. Vehicle If vehicle failed, fee expiry (28 Days) date (tick) No. Label No. FAILED PASSED (G) ROAD TEST Service Brake Performance G1 Park Brake Performance G2 ABS Self Check G3 Speedometer G4 Horn/Audible Warning Device G5 Rear View Mirrors G6 Exhaust G7 Visible Smoke G8 (H) SYSTEMS AND COMPONENTS Vehicle Structure H1 Fuel System Safe H2 Engine/Drivetrain H3 TRAILERS (A) FRONT LAMPS Forward Position Lamps A1 Other Lamps A2 (B) REAR LAMPS Rearward Position Lamps B1 Direction Indicator Lamps B2 Stop Lamps B3 Rear Reflectors B4 Registration Plate Lamps B5 Other Lamps B6 (C) STEERING SYSTEMS Hubs & Axles C1 Steering Mechanism C2 Suspension C3 Tyre & Wheel Condition C4 (Tread LF RF Depth in mm) LR RR (D) BRAKES If fitted - Rqd >2000KG Brake, Hoses & Components D1 Service Brake Performance D2 Breakaway Brakes D3 Parking Brake (>2500kg) D4 Mudguards E1 External Projections E2 Glazing E3 Drawbar/Towing Connections E4 Safety Chain (where rqd) E5 (F) SYSTEMS AND COMPONENTS Vehicle Structure F1 Copyright MOTOR TRADE ASSOCIATION (INC.) RE-ORDER REF 220M Version 10/14 Copyright - This form may not be copied or duplicated without written permission from the MTA

5 CONSUMER INFORMATION Complaints 1 The Inspecting Organisation identified on the front of this Checksheet has been appointed by the NZ Transport Agency to issue Warrants of Fitness (). Any questions or concerns relating to this inspection should first be raised with the issuing Inspection Organisation. 2 If, after you have raised your questions or concerns with the issuing Inspecting Organisation, you wish to take them further, please contact the NZ Transport Agency on free phone inspection limitations 1 The inspection is: (a) limited to an inspection to ensure compliance with certain vehicle and safety standards required by law; (b) generally only an external and visual inspection of a vehicle; (c) generally limited to an inspection of the items listed on the front of this Checksheet. 2 The issue of a vehicle represents that the vehicle meets legal requirements for the issue of a but only at the time of the examination. It does not represent an assurance that the vehicle: (a) is fit for any particular purpose; or (b) will remain in a warrantable condition for any period after the examination or until the next scheduled examination. 3 Vehicle defects which are not relevant in a examination, but which are nonetheless reported by the vehicle inspector or the customer at the time of the examination, will have no effect on whether the vehicle passes or fails its examination. Structural Integrity During the check the structural integrity of the vehicle is checked by outward visual appearance. This is in line with the NZ Transport Agencies requirements that the is primarily a visual inspection. Unless the customer allows panels to be removed, or a more probing check to be carried out, no responsibility can be taken for defects not visible during the examination. Operator obligation to ensure the vehicle is maintained in safe condition The operator of a vehicle has a continuing obligation to maintain the vehicle to a warrantable state of fitness at all times, whether the vehicle has a current or not. If the vehicle operator suspects that the vehicle is not in a warrantable condition the operator should cease to operate the vehicle, seek assessment and, if necessary, repair the vehicle. The vehicle may be driven solely for the purpose of bringing it into compliance and it is safe to be operated for that purpose. The should not be relied on as an indication of vehicle condition A should not be relied on as an assurance as to the overall condition or safety of a vehicle. There are a number of aspects about a vehicle s safety and performance which are not considered as part of a examination. If they are included in the examination then they may only become relevant, in terms of the vehicle s safety or performance, after the examination. If an assessment is required of a vehicle s overall safety and condition (or of items outside a examination) then these should be specifically requested of the vehicle inspector, in addition to the examination. The is not a Pre-purchase examination A is not intended as a pre-purchase inspection. It is the responsibility of a purchaser to ascertain the condition of a vehicle before purchase of the vehicle. A pre-purchase inspection is recommended. Most MTA member inspection agencies are able to provide a pre-purchase inspection. Consumer Guarantees Act 1993 Except to the extent that the Inspecting Organisation identified on the front of this checksheet may have lawfully contracted out of the Consumers Guarantees Act 1993, nothing in this checksheet or consumer information limits a customer s rights under that Act.

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