Checklist for damage diagnosis in the event of an accident, form

OF60.00-P-1000-01LF	Checklist for damage diagnosis in the event of an accident, form
	000 588 01 23 00 Karosserie-Richtanlage		WS60.00-P-0023K

Model

222

____________________________________________________________________________________________________________________
Service outlet/Operation no.	Customer


	__________________________________________________________
	Vehicle identification number:	Repair order no.

	__________________________________________________________
	Tester: Name	Date

____________________________________________________________________________________________________________________
License plate number Initial registration Model	Engine no.	Odometer reading: km/miles

Accident information from customer:

____________________________________________________________________________________________________________________

Workshop remarks:

____________________________________________________________________________________________________________________


Damage covered by comprehensive insurance:	☐	Damage covered by third-party liability insurance:	☐

Tire tread depth:

Left front:__________mm	Right front:__________mm

Left rear:__________mm	Right rear:__________mm


Performed:		Initial condition
	Vehicle exterior:
		OK	Not OK

☐	Check condition of vehicle exterior.	☐	☐
☐	Check condition of vehicle gap dimensions.	☐	☐

Checklist for vehicle exterior:
Front area of vehicle
Visual inspection of detachable parts		OK	Not OK	Damage	Appraisal
					Xenon repair kit	New part

Front area		☐	☐	__________________________________	☐	☐
Engine hood		☐	☐	__________________________________	☐	☐
Fender	Left	☐	☐	__________________________________	☐	☐
	Right	☐	☐	__________________________________	☐	☐
Bumper		☐	☐	__________________________________	☐	☐
Lamp units		☐	☐	__________________________________	☐	☐
Windows		☐	☐	__________________________________	☐	☐
Front doors		☐	☐	__________________________________	☐	☐
Other detachable parts		☐	☐	__________________________________	☐	☐

Checklist for vehicle exterior:
Rear area of vehicle
Visual inspection of detachable parts		OK	Not OK	Damage	Appraisal
					Xenon repair kit	New part

Fender	Left	☐	☐	__________________________________	☐	☐
	Right	☐	☐	__________________________________	☐	☐
Rear center section		☐	☐	__________________________________	☐	☐
Trunk lid		☐	☐	__________________________________	☐	☐
Bumper		☐	☐	__________________________________	☐	☐
Lamp units		☐	☐	__________________________________	☐	☐
Windows		☐	☐	__________________________________	☐	☐
Rear doors		☐	☐	__________________________________	☐	☐
Other detachable parts		☐	☐	__________________________________	☐	☐

Remarks on vehicle exterior:

____________________________________________________________________________________________________________________

________________________________

Date and signature of inspector

Checklist for vehicle gap dimensions:
Front area of vehicle
Visual inspection of gap dimensions	Dimension	OK	Not OK	Damage	Appraisal		Completed
					Xenon repair kit	New part

Engine hood to radiator trim	C	☐	☐	__________________________________	☐	☐	☐
Protrusion of radiator trim/engine hood		☐	☐	__________________________________	☐	☐	☐
Engine hood to bumper	D	☐	☐	__________________________________	☐	☐	☐
Bumper to headlamp	E	☐	☐	__________________________________	☐	☐	☐
Engine hood to headlamp	B	☐	☐	__________________________________	☐	☐	☐
Engine hood to fender	A	☐	☐	__________________________________	☐	☐	☐
Engine hood to fender	A1	☐	☐	__________________________________	☐	☐	☐
Front door to fender	G	☐	☐	__________________________________	☐	☐	☐

Checklist for vehicle gap dimensions:
Rear area of vehicle
Visual inspection of gap dimensions	Dimension	OK	Not OK	Damage	Appraisal		Completed
					Xenon repair kit	New part

Front/rear door to roof paneling, side	F	☐	☐	__________________________________	☐	☐	☐
Front door to rear door	H	☐	☐	__________________________________	☐	☐	☐
Front door cover to rear door cover	J	☐	☐	__________________________________	☐	☐	☐
Rear door to side section, bottom	I	☐	☐	__________________________________	☐	☐	☐
Fuel filler flap	O	☐	☐	__________________________________	☐	☐	☐
Trunk lid to top of fender	K	☐	☐	__________________________________	☐	☐	☐
Fender to taillamp	N	☐	☐	__________________________________	☐	☐	☐
Taillamp to bumper	L	☐	☐	__________________________________	☐	☐	☐
Trunk lid to bumper	M	☐	☐	__________________________________	☐	☐	☐
Trunk lid to bumper	M1	☐	☐	__________________________________	☐	☐	☐

Remarks on vehicle gap dimensions:

____________________________________________________________________________________________________________________

________________________________

Date and signature of inspector


Performed:		Initial condition
	Chassis:
		OK	Not OK

☐	Check condition of chassis components and vehicle underside.	☐	☐
☐	Perform wheel alignment check, if required.	☐	☐

Checklist for chassis components:
Visual inspection of suspension	OK	Not OK	Damage	New part

Complete wheels	☐	☐	__________________________________	☐
Front axle carrier	☐	☐	__________________________________	☐
Steering components	☐	☐	__________________________________	☐
Transverse control arm and wheel suspension	☐	☐	__________________________________	☐
Suspension strut and shock absorber	☐	☐	__________________________________	☐
Strut rod	☐	☐	__________________________________	☐
Spring control arm	☐	☐	__________________________________	☐

Remarks on chassis components:

____________________________________________________________________________________________________________________

________________________________

Date and signature of inspector


Performed:		Initial condition
	Visual inspection of structural components:

		OK	Not OK

☐	Perform visual inspection on front end structural components.	☐	☐
	Note: Before the structural components are inspected, the corresponding detachable parts must be removed.
	In the event of cracks, creases and/or deformation (exception), the affected component must always be replaced. Otherwise the required minimum strength of the structural components cannot be guaranteed.
	Exception, in case of deformation only: - Longitudinal members (extruded parts) may be capable of being straightened. - Upper front longitudinal members can be straightened.

Checklist for aluminum structural components at front end:
Visual inspection of structural components		OK	Not OK	Damage	Appraisal
					Xenon repair kit	New part

Suspension strut tower (casting)	Left	☐	☐	__________________________________		☐
	Right	☐	☐	__________________________________		☐
Longitudinal member (extruded)	Left	☐	☐	__________________________________	☐	☐
	Right	☐	☐	__________________________________	☐	☐
Longitudinal member (casting)	Left	☐	☐	__________________________________		☐
	Right	☐	☐	__________________________________		☐
Upper front longitudinal member	Left	☐	☐	__________________________________	☐	☐
	Right	☐	☐	__________________________________	☐	☐
Cross member below windshield (casting)		☐	☐	__________________________________		☐
Pedal floor cross member	Left	☐	☐	__________________________________		☐
	Right	☐	☐	__________________________________		☐

Remarks on structural components:

____________________________________________________________________________________________________________________

________________________________

Date and signature of inspector


Performed:		Initial condition
	Measurement of structural components:
		OK	Not OK

☐	Perform measurements on front end structural components.	☐	☐
	Note: Measurement of the structural components only in combination with the recommended electronic measuring systems.

	Note: Before the structural components are measured, the corresponding detachable parts must be removed and the bolts loosened between the flexural member and the crash box, between the crash box and the longitudinal member, and between the front axle carrier and the body.

	In the event of cracks, creases and/or deformation (exception), the affected component must always be replaced. Otherwise the required minimum strength of the structural components cannot be guaranteed.
	Exception, in case of deformation only: - Longitudinal members (extruded parts) may be capable of being straightened. - Upper front longitudinal members can be straightened.

Checklist for damage diagnosis in the event of an accident, form

P62.10-2229-08

P62.10-2230-08

Remarks on measurement of structural components:

____________________________________________________________________________________________________________________

________________________________

Date and signature of inspector

All check performed?	YES	☐	NO	☐

____________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________

________________________________		________________________________
Date and signature of service advisor		Date and signature of mechanic

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