Sample road testing for drivers of automobiles, vans and light trucks

Driver’s Name (print):

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Operator’s License:

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Issuing State:

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License Number:

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Class:

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Endorsement(s):

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Expiration:

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Type of Vehicle Employed in Evaluation: 

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Instructions to examiners

Possession of a driver’s license does not verify that a driver can safely operate a vehicle. All drivers should be required to take a road test to evaluate their safety awareness. This checklist can help a supervisor administer a road test. Place a check mark: in the Yes box for items that the driver performs satisfactorily; in the No box when further training is recommended; and in the N/A box when the item does not apply to the operation of the vehicle that the driver will be assigned. Additional criteria may be necessary to meet a company’s specific needs.

 

Pre-trip inspection	YES	NO	N/A
Checks general condition of vehicle
Checks condition of tires
Checks lighting devices
Checks horn and windshield wipers
Checks and adjusts rearview mirrors

 

Placing vehicle in operation	YES	NO	N/A
Uses seat belt
Starts vehicle properly
Tests operation of brakes
Shifts gears properly

 

Driving	YES	NO	N/A
Drives with both hands on the steering wheel
Accelerates, steers, and brakes smoothly
Keeps alert and checks for traffic conditions, especially at intersections
Checks mirrors frequently
Prepares to stop vehicle at an intersection, even if traffic signal is green
Maintains proper speed for conditions, within speed limit
Uses directional signals properly
Stops vehicle in proper location
Does not allow vehicle to roll, while it should be stopped
Only passes in safe location, where legally allowed, and within legal speed limit
Passes safely — that is, checks for vehicles ahead and behind, uses directional signals, warns the driver ahead of intent to pass, and leaves sufficient space before cutting back into lane

 

Remarks:

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Check one of the following:

                  

Road Test Conducted by (print):

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Signature:

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Location / Telephone Number:

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Date of Road Test:

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171-1177 (4/15)             LC 2015-117