FORM A.I.R — PDF Template Creator

Report Data Entry

0 / 20 filled

📋 Header Information

Cr. No

Section

Station

📌 Basic Details (1–4)

1 Designation & Address of Officer

2 Date & time of receipt of requisition

3 Date, time & place of accident

4 Date, time & place of inspection

🚗 Vehicle Particulars (5)

(a) Regn No.

(b) Make

(c) Model

(d) Type

(e) Seating Capacity

(f) Colour

(g) Class

(h) Owner Name & Address

👤 Driver Details (6–7)

6 Driver Name & Address

7 D.L. No

Badge No

Validity

📄 Documents (8–12)

8 Fitness Certificate Expiry / RRC

9 Period of Validity of Permit

10 Insurance Details

11 Vehicle on Trade Plate?

12 Damage Details

🔍 Inspection Details (13–20)

13a Nature of injuries

13b Person injured/dead details

14a Efficiency of foot brake

14b Efficiency of hand brake

14c Even or not

15a Hydraulic/air pressure

→ (i) Want of fluid

→ (ii) Leak or defect

15b If mechanical

→ (i) Lack of lubrication

→ (ii) Slackness in adjustment

→ (iii) Wornout parts

16 Failure of hand brake

→ (i) Lack of lubrication

→ (ii) Slackness in adjustment

→ (iii) Wornout parts

17 Steering / Handle bar

18 Condition of tyres

19 Opinion of Inspection Officer

20 Brief description / sketch

✍️ Footer / Signature

Inspection Location

Report Date

To (Recipient Officer)

Copy Submitted To

Copy Location

Signed By (Designation)

Signed Office

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