VEHICLE DELIVERY ATTACHMENT

PO No. : Leesse :
Type/Brand : Machine No. :
Vehicle Registration Name : Chassis No. :
Police No. : Color/Year :
KM :

With the following equipment and conditions

Not
Vehicle Equipment Attached Description
Attached
Vehicle Number
KEUR
Inginition Key
Radio/Tape and Speaker
AC
Spare Tire
Jack and Handle
Toolkit and Wheel Wrench
P3K Box
Emergency Triangle
Service Book

Vehicle Condition Good Bad Description

Machine
Cabin
Rear Body
Rearview Mirror
Interior (Head Lining, Door Trim, etc.)
Dashboard
Safety Belt
Car Seat
Window Glass
Power Steering
Lighting
Water Cooler
Wiper and Washer
Battery (Accu)

Additional Accessories Good Bad Description

Additional Bodywork Good Bad Description

NOTES

Handed over by Received by Acknowledge by

Date Date Date

Name Name Name