Checklist for damage diagnosis in the event of an accident, form · of6000p100001lwe · Mercedes-Benz WIS

OF60.00-P-1000-01LWE

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

Model

213

________________________________________________________________________________________________________________________________
Company-owned sales and service outlet/Dealer 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
					Repair	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
					Repair	New part

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

Remarks on vehicle exterior:

________________________________________________________________________________________________________________________________

________________________________

Date and signature of mechanic

Checklist for vehicle gap dimensions:
Front area of vehicle
Check of gap dimensions	Dimension	OK	Not OK	Damage	Appraisal
					Repair	New part	Completed

Engine hood to fender	A	☐	☐	______________________	☐	☐	☐
Engine hood to headlamp	B	☐	☐	______________________	☐	☐	☐
Engine hood to radiator trim/soft nose	C	☐	☐	______________________	☐	☐	☐
Protrusion of radiator trim/soft nose, engine hood		☐	☐	______________________	☐	☐	☐
Engine hood to bumper	D	☐	☐	______________________	☐	☐	☐
Bumper to headlamp	E	☐	☐	______________________	☐	☐	☐
Front door to fender	G	☐	☐	______________________	☐	☐	☐

Checklist for vehicle gap dimensions:
Rear area of vehicle
Check of gap dimensions	Dimension	OK	Not OK	Damage	Appraisal
					Repair	New part	Completed

Front door to rear door	H	☐	☐	______________________	☐	☐	☐
Rear door to side section, bottom	I	☐	☐	______________________	☐	☐	☐
Front door cover to rear door cover	J	☐	☐	______________________	☐	☐	☐
Trunk lid to fender at rear, top	K (model 213.0/1)	☐	☐	______________________	☐	☐	☐
Taillamp to bumper	L	☐	☐	______________________	☐	☐	☐
Trunk lid to bumper	M (model 213.0/1)	☐	☐	______________________	☐	☐	☐
	M1 (model 213.0/1)	☐	☐	______________________	☐	☐	☐
Rear sidewall to taillamp	N	☐	☐	______________________	☐	☐	☐
Fuel filler flap	O	☐	☐	______________________	☐	☐	☐
Rear side window to rear triangular window	P (model 213.2)	☐	☐	______________________	☐	☐	☐
Roof to rear spoiler	Q (model 213.2)	☐	☐	______________________	☐	☐	☐
Sidewall to rear spoiler	R (model 213.2)	☐	☐	______________________	☐	☐	☐
Sidewall to liftgate	S (model 213.2)	☐	☐	______________________	☐	☐	☐
Outside of taillamp to inside of taillamp	T (model 213.2)	☐	☐	______________________	☐	☐	☐
Center of liftgate to rear bumper	U1 (model 213.2)	☐	☐	______________________	☐	☐	☐
Outside of liftgate to rear bumper	U2 (model 213.2)	☐	☐	______________________	☐	☐	☐

Remarks on vehicle gap dimensions:

________________________________________________________________________________________________________________________________

________________________________

Date and signature of mechanic


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:
Front area of vehicle
Visual inspection of chassis components	OK	Not OK	Damage	New part

Complete wheels	☐	☐	_________________________________________	☐
Front axle carrier	☐	☐	_________________________________________	☐
Steering components	☐	☐	_________________________________________	☐
Transverse control arm and wheel suspension	☐	☐	_________________________________________	☐
Suspension strut	☐	☐	_________________________________________	☐
Stabilizer bar or stabilizer bar linkage	☐	☐	_________________________________________	☐
Strut rod	☐	☐	_________________________________________	☐
Spring control arm	☐	☐	_________________________________________	☐

Remarks on chassis components:

________________________________________________________________________________________________________________________________

________________________________

Date and signature of mechanic

Checklist for chassis components:
Rear area of vehicle
Visual inspection of chassis components	OK	Not OK	Damage	New part

Complete wheels	☐	☐	_________________________________________	☐
Rear axle carrier	☐	☐	_________________________________________	☐
Wheel suspension	☐	☐	_________________________________________	☐
Shock absorber	☐	☐	_________________________________________	☐
Spring control arm	☐	☐	_________________________________________	☐
Axle shaft	☐	☐	_________________________________________	☐
Camber strut	☐	☐	_________________________________________	☐
Tie rod	☐	☐	_________________________________________	☐
Thrust arm	☐	☐	_________________________________________	☐
Strut rod	☐	☐	_________________________________________	☐
Stabilizer bar or stabilizer bar linkage	☐	☐	_________________________________________	☐

Remarks on chassis components:

________________________________________________________________________________________________________________________________

________________________________

Date and signature of mechanic


Performed:		Initial condition:
	Visual inspection of structural components:

		OK	Not OK

☐	Perform visual inspection on structural components.	☐	☐
	Note: Before the structural components are inspected, the corresponding detachable parts must be removed.
	The respective structural component must always be replaced in the event of any cracks, creases or deformation (exception). Otherwise the required minimum strength of the structural components cannot be guaranteed.
	Exception, in case of deformation only: The connecting flange on the suspension strut tower for the front module carrier can be straightened under certain conditions.

Checklist for structural components:
Front area of vehicle
Visual inspection of structural components		OK	Not OK	Damage	Appraisal
					Repair	New part

Suspension strut tower	Left	☐	☐	_______________________________________		☐
	Right	☐	☐	_______________________________________		☐
Connecting flange on suspension strut tower for front module carrier	Left	☐	☐	_______________________________________	☐	☐
	Right	☐	☐	_______________________________________	☐	☐

Checklist for structural components:
Rear area of vehicle
Visual inspection of structural components		OK	Not OK	Damage	Appraisal
					New part

Cross member above rear axle		☐	☐	_______________________________________	☐
Longitudinal member console	Left	☐	☐	_______________________________________	☐
	Right	☐	☐	_______________________________________	☐
Damper strut dome	Left	☐	☐	_______________________________________	☐
	Right	☐	☐	_______________________________________	☐

Remarks on structural components:

________________________________________________________________________________________________________________________________

________________________________

Date and signature of mechanic


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

☐	Carry out measurements on the structural components.	☐	☐
	Note: Measurement of structural components only in combination with approved 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 of the front axle carrier and the body.


	The respective structural component must always be replaced in the event of any cracks, creases or deformation (exception). Otherwise the required minimum strength of the structural components cannot be guaranteed.
	Exception, in case of deformation only: The connecting flange on the suspension strut tower for the front module carrier can be straightened under certain conditions.
	Information on straightening and reshaping, see "Information on machining aluminum components and vehicles"

Checklist for structural components:
Front area of vehicle
Measurement of structural components		Actual value (deviation) in			Appraisal
		"X"	"Y"	"Z"	OK	Repair	New part

Suspension strut tower:
Measuring point 4	Left	____	____	____	☐		☐
	Right	____	____	____	☐		☐

Connecting flange on suspension strut tower for front module carrier:
Measuring point 5	Left	____	____	____	☐	☐	☐
	Right	____	____	____	☐	☐	☐

Checklist for structural components:
Rear area of vehicle
Measurement of structural components		Actual value (deviation) in			Appraisal
		"X"	"Y"	"Z"	OK	New part

Crossmember above rear axle:
Measuring point 6	Left	____	____	____	☐	☐
	Right	____	____	____	☐	☐
Measuring point 7	Left	____	____	____	☐	☐
	Right	____	____	____	☐	☐

Longitudinal member mounting console:
Measuring point 8	Left	____	____	____	☐	☐
	Right	____	____	____	☐	☐
Measuring point 9	Left	____	____	____	☐	☐
	Right	____	____	____	☐	☐

Shock-absorber strut tower:
Measuring point 10	Left	____	____	____	☐	☐
	Right	____	____	____	☐	☐

Remarks on structural components:

________________________________________________________________________________________________________________________________

________________________________

Date and signature of mechanic

All check performed?	YES	☐	NO	☐

Remarks: _____________________________________________________________________________________________________________________

________________________________________________________________________________________________________________________________

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