MOTOR VEHICLE DESCRIPTION CHECKLIST



GSA MOTOR VEHICLE STANDARD DESCRIPTION

AND VEHICLE CHECKLIST

NOTE: Please complete the necessary blanks and place an (X) in the correct feature/description.

Agency: US Coast Guard Report No. / Vehicle No._________________________________

Manufacturer FORD Make F150

Body Style PICK-UP Mode TRUCK

Year Manf 1999 VIN 1FTZF1720XNB56832

Capacity 3 PASSENGER Transmission Drive Type AUTOMATIC

Body Color WHITE Manual or Automatic AUTOMATIC Tires (Make/Model) NIXEON P235/70R16

No. Doors 2 Fuel Type GAS FSC UNK Number of Cylinders 6

Pickup Bed (narrow or wide) NARROW Tonnage ¾ Feet Long UNK GVW 5600

Odometer Reading ODOMETER IS NOT WORKING Is Odometer Reading True/Actual or Mileage Unknown UNKNOWN

Please check/list any special features and accessories:

|□ 4x4 |□ Anti-Lock brakes |□ Extended Cab |□ Power Brakes |□ Sunroof |

|□ 4x6 |□ Anti-Theft |□ Fabric Interior |□ Power Locks |□ Tilt Steering |

|□ 6x6 |□ AWD |□ Hub Caps |□ Power Mirrors |□ Tire Chains |

|□ Airbags |□ Cassette |□ Intermittent Wipers |□ Power Steering |□ Towing Package |

|□ Auxiliary gas tanks |□ CD Player |□ Keyless Entry |□ Power Windows |□ Utility Body |

|□ Air Conditioning |□ Cruise Control |□ Leather Interior |□ Rear Defrost |□ Winch |

|□ Alloy Wheels |□ Crew Cab |□ Manuals |□ Side Packs |□ Power Seats |

|□ AM/FM radio |□ Dual Wheels | | | |

List other vehicle features/accessories not listed above: _________________________________________________

_____________________________________________________________________________________________

Please check/describe vehicle condition:

|□ A/C Inoperable |□ Electrical Problems |□ Headlights Inoperable |□ Starter Bad-Won’t Start |

|□ Battery(s) Dead/Missing |□ Exhaust System Problem |□ Keys Missing |□ Speedometer Inoperable |

|□ Body Damage, Rust |□ Fire Damage |□ Parking Lights Inoperable |□ Suspension Problems |

|□ Brakes Worn |□ Flood Damage |□ Mechanical Problems |□ Transmission Leak |

|□ Dents, Minor |□ Fuel Gauge Inoperable |□ Minor Scratches |□ Trans. Repairs Req. |

|□ Engine Part(s) Required |□ Interior Damaged |□ Odometer Inoperable |□ Visual Blemishes |

|□ Engine Repairs Req. |□ Hazard Lights Inoperable |□ Oil Leaks |□ Windshield Cracked |

|□ Engine Smoke |□ Horn Inoperable |□ Radiator Leak |□ Wipers Inoperable |

|□ Axel Damage |□ Frame Damage |□ Tires(condition) WORN | |

Has the vehicle been in a major accident or had a major repair (Y/N)?

If yes, please describe: __________________________________________________________________________

Describe any other vehicle deficiencies not listed above: _______________________________________________ _____________________________________________________________________________________________

Please Check Appropriate Condition Code:

__Code 1 = Excellent

__Code 4 = Usable

__Code 7 = Repairable (Mechanical and/or accident repairs required)

__Code S = Scrap (Major mechanical or accidents repairs required.)

__Code X = Salvage (Not to be “Titled” for highway use.)

Return Completed Form along with SF-120 or SF 126 to the respective regional GSA sales office responsible for the property.

GENERAL SERVICES ADMINISTRATION

PROPERTY MANAGEMENT DIVISION

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