• Pursuant to FMCSR 396.3(b), the following is a record is a record of maintenance for the above named vehicle. This includes, but is not limited to, repairs, new parts, tires and lubrications.
  • Additionally, the following is a list of inspections and maintenance services to be performed.







  • I certify that this is an accurate and true record of vehicle maintenance. I also certify that I have in my possession Bills, Records or Receipts and/or other evidence to verify that the above repairs were done and parts installed.