Vehicle Owner

Vehicle Manufacturer

Address of Garage / Repair Place

Contact Person

Type plate with serial number

Serial number stamped into the axle stub (right side)

* One of both fields is mandatory

Affected position on vehicle

Left Right Axle lift
1st axle
2nd axle
3rd axle
4th axle
5th axle
L
R

Vehicle Type

1 Axle Semi-Trailer
2 Axle Trailer
2 Axle Semi-Trailer
3 Axle Trailer
3 Axle Semi-Trailer
4 Axle Trailer
4 Axle Semi-Trailer
2 Axle Center Trailer
Other
3 Axle Center Trailer

Body Type

Box
Platform
Tank
Concrete Mixer
Silo
Demountable
Low loader
Tipper
Traktor EBS: Yes No
Trailer EBS: Yes No