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