WAHVA - VEHICLE ROADWORTHINESS INSPECTION/CERTIFICATION REGISTER ___________________________________________________________________ Operator Business Name Vehicle Roadworthy Type (P Mover Vehicle Vehicle Year of Vehicle RWC Certificate Vin / Chassis No. Signed / Trailer / Registration Make Manufacture Owner Undertaken By Date Dolly) VERIFICATION: the vehicle/s aligned with your name & signature Your name and signature in the “Signed” column deems you are a suitably qualified person, have inspected and certify them to be roadworthy, at the corresponding Roadworthy Certificate date. Your name and signature below declares that all people named in the Undertaken column are suitably qualified, have inspected the vehicle/s aligned with their name “RWC By” and certified them to be roadworthy at the corresponding Roadworthy Certificate date and that an individual signed Roadworthy certificate / inspection / checklist is available for each vehicle. ____________________________ _______________________ ____________________ Name Signature Date
WAHVA - VEHICLE ROADWORTHINESS INSPECTION/CERTIFICATION REGISTER ___________________________________________________________________ Operator Business Name Vehicle Type (P Mover / Trailer / Dolly) Vehicle Registration Vehicle Make Vin / Chassis No. Year of Manufacture Vehicle Owner Roadworthy Certificate Date RWC Undertaken By Signed VERIFICATION: Your name and signature in the “Signed” column deems you are a suitably qualified person, have inspected the vehicle/s aligned with your name & signature and certify them to be roadworthy, at the corresponding Roadworthy Certificate date. Your name and signature below declares that all people named in the “RWC Undertaken By” column are suitably qualified, have inspected the vehicle/s aligned with their name and certified them to be roadworthy at the corresponding Roadworthy Certificate date and that an individual signed Roadworthy certificate / inspection / checklist is available for each vehicle. ____________________________ _______________________ ____________________ Name Signature Date
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