Free template
DOT annual inspection form.
Short answer: A DOT annual inspection checks the vehicle against Appendix A to Part 396 (brake system, coupling devices, exhaust system, fuel system, lighting devices, safe loading, steering mechanism, suspension, frame, tires, wheels and rims, windshield glazing, windshield wipers, motorcoach seats, rear impact guard) and the report must identify the inspector, carrier, date, vehicle and components inspected, with the inspector's certification, per 49 CFR 396.21.
Periodic (annual) inspection report
| Motor carrier or operator | |
|---|---|
| Address | |
| Date of inspection | |
| Vehicle type and unit number | |
| VIN or identification | |
| Inspector name | |
| Inspector qualified under 396.19 (yes / no) | |
| Location of inspection |
| Item | Pass | Fail | Notes |
|---|---|---|---|
| Brake System | |||
| Coupling devices | |||
| Exhaust System | |||
| Fuel System | |||
| Lighting Devices | |||
| Safe Loading | |||
| Steering Mechanism | |||
| Suspension | |||
| Frame | |||
| Tires | |||
| Wheels and Rims | |||
| Windshield Glazing | |||
| Windshield Wipers | |||
| Motorcoach Seats | |||
| Rear Impact Guard |
I certify that this vehicle has passed all the inspection items for the annual vehicle inspection in accordance with 49 CFR Part 396.
Signature: ______________________ Date: __________
Areas from Appendix A to Part 396; report fields from 49 CFR 396.21; eCFR content date 2026-10-28.
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