State of Ohio Official Vehicle Inspection Report and Form

STATE OF OHIO: OFFICIAL VEHICLE INSPECTION REPORT

PURPOSE: This form serves as a formal record of vehicle condition, identification, and safety compliance for the State of Ohio. This document must be completed in its entirety by an authorized inspector or certified agent.

I. VEHICLE IDENTIFICATION DATA

• Make: __________________________
• Model: __________________________
• Year: __________________________
• Vehicle Identification Number (VIN): ______________________________________
• Odometer Reading: __________________________ Miles/Kilometers
• License Plate Number: __________________________
• State of Registration: __________________________
• Body Type: __________________________
• Primary Color: __________________________

II. OWNER / REGISTRANT INFORMATION

• Full Legal Name: ________________________________________________
• Street Address: ________________________________________________
• City: __________________________ State: OH Zip: ___________
• Phone Number: __________________________
• Email Address: ________________________________________________

III. INSPECTION CRITERIA & STATUS

(Check [X] the appropriate box for each category)

IV. INSPECTOR’S FINDINGS & CERTIFICATION

Inspector Comments: ________________________________________________________________________________ ________________________________________________________________________________

Certification: I, the undersigned authorized inspector, hereby certify that I have performed a physical inspection of the vehicle described herein on this date, ___________ (Date), and the information provided is true and accurate to the best of my professional knowledge.

V. SIGNATURE BLOCKS

INSPECTOR NAME (Printed): __________________________________________ INSPECTOR CERTIFICATION ID: __________________________________________

SIGNATURE OF INSPECTOR: ____________________________________ DATE: ___________

OWNER ACKNOWLEDGMENT: I, the vehicle owner/representative, acknowledge that I have received a copy of this inspection report and understand the findings recorded herein.

SIGNATURE OF OWNER: ________________________________________ DATE: ___________

VI. ADMINISTRATIVE USE ONLY

• Inspection Facility Name: __________________________________________
• Facility Address: ________________________________________________
• Transaction Reference Number: ______________________________________
• Fee Paid: $__________ | Receipt No: __________________________