VIC - Test Your Printer

Test Your Printer

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SAMPLE

Vehicle Inspection Report - Test Page

Vehicle Inspection Connection (VIC)

Texas Department of Public Safety

Vehicle Inspection Report

PLEASE RETAIN FOR YOUR RECORDS

Overall Result:

Pass

Test Date/Time:

01/01/2020 00:00 AM

Inspection Class:

1YR

Inspection Exp Date:

01/01/2020 00:00 AM

Vehicle Information

VIN:

SAMPLEVIN

License Number:

TX SAMPLE

Registration County:

WILLIAMSON

Vehicle Type:

Passenger Car

Year:

2020

Make:

SAMPLE

Model:

SAMPLE

Fuel Type:

GAS

Odometer Reading:

11111

Insurance Exp:

01/01/2020

Insurance Mileage Exp:

Fees

Inspection Fee:

$7.00

Repair Cost:

$0.00

Total:

$7.00

Station Information

Station #:

7P046182

Station Name:

DPS TEST STATION

Station Address:

123 SAMPLE STREET

SAMPLE CITY, TX 12345

Inspector Name:

JOE SAMPLE

Inspection Information

Inspection Type:

ONE YEAR SAFETY ONLY

Test Type:

INITIAL

Affidavit Type:

Not operated in county

I CERTIFY THAT I HAVE PROPERLY PERFORMED THE VEHICLE INSPECTION ACCORDING TO THE STATE REGULATIONS AND PROCEDURE MANUALS, AND AS THE UNDERSIGNED DULY APPOINTED INSPECTOR, HEREBY CERTIFY THAT I HAVE PHYSICALLY EXAMINED THE MANUFACTURER’S VEHICLE IDENTIFICATION NUMBER OF THE MOTOR VEHICLE DESCRIBED ABOVE.

Certified Inspector Signature

Date