Assigned Inspection Certificate

Safety CertificateCaravans and Trailers(over 0.75 tonne ATM up to and including 3.5 tonne ATM)Transport Operations (Road Use Management) Act 1995

Certificate NumberUnassigned Safety CertificateIt is recommended that this certificate is presented when registering ortransferring your vehicle. Until this certificate is presented at a Department ofTransport and Main Roads Customer Service Centre, the vehicle registration cannot be transferred online. For more information about online transfers, visit www.qld.gov.au/onlineregotransfer.

Inspection Station and Examiner details

Vehicle details

Privacy Statement: The Department of Transport and Main Roads collects the information on this form under the Transport Operations (Road Use Management) Act for the purpose of administering the AIS scheme. Where required the department usually discloses some or all of this information to the Queensland Police Service and interstate and federal government agencies. The department will not disclose your personal information to any other third party without your consent unless authorised or required to by law.

TRB Forms Area Form F2499_ICOLTUN V02 September 2017

This safety certificate does not need to be displayed on the vehicle offered for sale.You must produce this safety certificate for inspection by the prospective buyer or buyer's agent on request.Note: Failure to produce this certificate may result in enforcement action.This safety certificate is valid for: ○ Licensed Motor Dealers – 3 months ○ Private Sales – 2 monthsThis certificate or certificate number must be provided to the acquirer of the vehicle at transfer of registration.

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Vehicle Registration Plate No.: w80455Vehicle Make: jayco Vehicle Model: journeyState of vehicle registrationplate No.: vicBody shape: caravanVIN: 6AM000000F1T55350Chassis Number: 6AM000000F1T55350Gas Certificate: 1423291Compliance Type: PlateDate on plate: 5/2015Vehicle colour: white / blackTare: 2053kgATM: 2528kg

AIS name: Mr Safety CertificateAIS number: 11787AIS address: 10 Learjet Dr, Caboolture, 4510

Name of Examiner: kyle collinsExaminer's number: 20845

Final inspection ­ Passed InspectionOdometer reading Inspection date and time

  Not Applicable   10:26 am, 23/10/2019

 Lamps (lights) and Electrical Components   Body, Chassis and Frame   Tow Couplings   Steering and Suspension   Wheels and Tyres   Brakes    Failed/then passed  

 Vehicle Safety Features   Identification   Modifications  

LT­30396813­7