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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