Truck Identification Form

HEAVY EQUIPMENT IDENTIFICATION FORM

INSURED/CLAIMANT: CLAIM #:

Date Received by appraiser: Date Unit Inspected:

Year: Make: Model #:

Type:

VIN #:

Engine: (Make) Model: H/P: Cyl: Pony Motor:

Hour Meter Reading: Over-Haul : Type: Hrs. Since:

Transmission: (Model) Speeds:

ROPS: EROPS: FOPS: HEATER A/C

Dozer Blade Type: Size:

Front Bucket Type: Size: xx: 27:2=Cubic Yards

Rear Bucket (width) ” Ripper #Teeth Scarifier # Teeth

Attachment: Type Length Cable: Hydraulic:

Boom: # Sections: Tubular Angle Iron Length Pin Bolt Frame Dim

WHEEL TYPE ONLY

Tires (TYPE) Size: Front: Rear:

Remaining Tread%: LF RF LR RR Foam Filled

Other Tires: Wheel Power: P/S

CRAWLER TYPE

Track Length: Rail Height: Quantity of shoes:

Track Gauge: Shoe Width:

Under Carriage Condition: % Remaining:

Sprocket Cond.: Roller Condition:

Prior Damage:

Comments:

Appraiser: Date: