Current Owner: ______________________________
______________________________
Chassis No.: ______________________________
Series: [ ] I [ ] II [ ] II-SE
Engine Type: [ ] FWE [ ] Other __________
Engine No.: ______________________________
Gearbox: [ ] ZF S4-12 [ ] BMC [ ] BMC-CR [ ] Other __________
Condition: [ ] Running [
] Not Running [ ] In Storage
[ ] Dismantled [ ] Under Restoration [ ] Parts Car
[ ] Wreck
Usage: [ ] Daily Driver
[ ] Pleasure Driving [ ] Circuit Racing
[ ] Hill Climb [ ] Slalom
[ ] Rally
[ ] Concours
Weight: ____________________
FIA Papers: [ ] YES [ ] NO
Issued By: ____________________
Date: ____________________
Registration No.: _______________________________
Purchase Date: ___________________________
Restoration Date: ________________________
Engine Serviced By: ______________________
Original Mileage: ________________________
Mileage Since Last Rebuild:_______________
Recent Competition History:
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Previous Owners:
__________________________________________
__________________________________________
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Original Colour: ____________________
Current Colour: ____________________
Coats of Paint: ____________________
Exterior Finish Quality: [ ] Show [ ] Excellent [ ] Good
[ ] Fair [ ] Poor
Body Condition:
[ ] Show [ ] Excellent [ ] Good
[ ] Fair [ ] Poor
Subframe: [ ] Original [ ] Replaced _______________
Subframe Condition: [ ] New
[ ] Good [ ] Fair
[ ] Poor [ ] Dangerous
Accident Damage: [ ] YES [ ] NO
[ ] Left side _______________
[ ] Right side _______________
[ ] Front _______________
[ ] Back _______________
[ ] Rolled _______________
[ ] Fire _______________
Cavities Filled: [ ] NO [ ] YES _______________
Bumpers: [ ] Original [ ] Removed [ ] Replaced __________
Grill: [ ] Original [ ] Removed [ ] Replaced __________
Wiper arms: [ ] Original [ ] Removed [ ] Replaced __________
Other Body Modifications:
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Condition: [ ] Show
[ ] Excellent [ ] Good
[ ] Fair [ ] Poor
Trim:
[ ] Standard [ ] Royalite [ ] Removed
[ ] Replaced _______________
Original Trim Colour: ____________________
Current Trim Colour: ____________________
Weatherstripping: [ ] Original [ ] Removed [ ] Replaced __________
Gauges: Tachometer: [ ] Original [ ] Replaced __________
Fuel Gauge: [ ] Original [ ] Replaced __________
Speedometer: [ ] Original [ ] Replaced __________
Water temp/Oil pressure: [ ] Original [ ] Replaced __________
Ammeter: [ ] Original [ ] Replaced __________
Fuel: [ ] Original [ ] Replaced __________
Reinforced Pedal Box: [ ] YES [ ] NO
Reinforced Steering Rack: [ ] YES [ ] NO
Roll Cage: [ ] YES [ ] NO
Certificate: [ ] YES [ ] NO
Seat(s): [ ] Single Racing __________
[ ] Dual Racing
__________
[ ] Original
[ ] Other __________
Orientation: [ ] RHD [ ] LHD
Steering Wheel: [ ] Lotus Leather
[ ] Original Wood
[ ] Other __________
Fire Fighting System: [ ] Plumbed FIA Spec
[ ] Hand-held
[ ] Other __________
[ ] None
Battery Position: [ ] Boot [ ] Cabin
Harnesses: [ ] ___-point
[ ] None
Battery Type: ____________________
Ground: [ ] Positive [ ] Negative
Generator Type: [ ] Dynamo [ ] Alternator
Starter Motor: [ ] Original [ ] Replaced _______________
External Kill Switch: [ ] YES [ ] NO
Displacement: ____________________
Crank: [ ] Original [ ] Replaced __________
[ ] Reground __________
Shells: [ ] Original [ ] Replaced __________
Crack Tested: [ ] Yes __________ [ ] No
Engine Balanced: [ ] Yes __________ [ ] No
Compression Ratio: __________
Compression Test: [ ] Yes __________ [ ] No
Cylinder 1 __________
Cylinder 2 __________
Cylinder 3 __________
Cylinder 4 __________
Cylinder Liners: [ ] Original [ ] Replaced __________
Rods: [ ] Original [ ] Replaced __________
Rod Bolts: [ ] 7mm [ ] 9mm [ ] Other __________
Pistons: [ ] Original [ ] Replaced __________
Rings: [ ] Original [ ] Replaced __________
Camshaft: [ ] Original [ ] Replaced __________
Camshaft Bearings: [ ] 3 [ ] 5
Camshaft Lift [ ] .310” [ ] .360” [ ] Other __________
Timing Gear: [ ] Steel Chain [ ] Fibre Belt [ ] Replaced: __________
Valves: [ ] Original [ ] Replaced __________
Valve Springs: [ ] Original [ ] Replaced __________
Valve Seats: [ ] Original [ ] Replaced __________
Rear Oil Seal Rings: [ ] Original [ ] Replaced __________
Jack Shaft Bearings: [ ] Original [ ] Replaced __________
Oil Seals: [ ] Original [ ] Replaced __________
Remote Oil Filter: [ ] YES [ ] NO
Remote Oil Cooler: [ ] YES [ ] NO
Radiator: [ ] Original [ ] Replaced __________
Power: __________ bhp @ __________ rpm
Torque: __________ ft/lb @ __________ rpm
Transmission
Final Drive Ratio: [ ] 1:5.125
[ ] 1:4.875
[ ] 1:4.55
[ ] 1:4.22
[ ] 1:3.73
[ ] Other __________
LSD: [ ] NO [ ] YES __________
Clutch Type: [ ] Diaphragm [ ] Spring
Clutch Plate Size: [ ] 8.5”
[ ] 8”
[ ] Other __________
Clutch Cover: [ ] Original [ ] Replaced __________
Clutch Centre Plate: [ ] Original [ ] Replaced __________
Gearbox Shaft Bearing: [ ] Original [ ] Replaced __________
Synchro Hubs and Bearings: [ ] Original [ ] Replaced __________
Crown Wheel and Pinion: [ ] Original [ ] Replaced __________
Differential Output Shafts:[ ] Original [ ] Replaced __________
Differential Bearings: [ ] Original [ ] Replaced __________
Drive Shafts: [ ] Original [ ] Replaced __________
Wheel Bearings:
[ ] Original [ ] Sealed [ ] Replaced __________
Front Dampers:
[ ] Original [ ] Replaced __________
Front Damper Type:
[ ] Koni [ ] Spax
[ ] Biltstein
[ ] Leda [ ] Other __________
Front Springs: [ ] Original [ ] Replaced __________
Front Spring Rate: __________
Front Wishbones: [ ] Original [ ] Replaced __________
Front Top Arm: [ ] Original [ ] Replaced __________
Rear Dampers: [ ] Original [ ] Replaced __________
Rear Damper Type:
[ ] Armstrong [ ] Koni [ ] Spax
[ ] Biltstein [ ] Leda [ ] Other __________
Rear Springs: [ ] Original [ ] Replaced __________
Rear Spring Rate: __________
Rear Wishbones: [ ] Original [ ] Replaced __________
Uniball:
[ ] Rose Joints [ ] Rubber Balls
Circuit:
[ ] Single [ ] Dual
Front Calipers:
[ ] Original [ ] Replaced __________
[ ] Cast Iron [ ] Alloy
Rear Calipers:
[ ] Original [ ] Replaced __________
[ ] Cast Iron [ ] Alloy
Brake Disks: [ ] Original [ ] Replaced __________
Brake Pads: [ ] Original [ ] Replaced __________
Brake Hoses: [ ] Original [ ] Replaced __________
Master Cylinder:
[ ] Original [ ] Replaced __________
[ ] 0.625” [ ] 0.70”
[ ] 0.75”
Handbrake:
[ ] Flyoff [ ] Umbrella
[ ] Original [ ] Replaced __________ [ ] Removed
Carbeurator(s): [ ]
Dual Weber 40 DCOE
[ ] Dual SU H4
[ ] Single SU H4
[ ] Other __________
Intake Manifolds: _______________
Air Intake: [ ] Nose [ ] NACA Duct [ ] Other __________
Air Filtration: __________
Fuel Pump: [ ] Electric [ ] Mechanical
Fuel Type: [ ] Leaded _____
[ ] Unleaded _____
Fuel Tank: [ ] Original
[ ] FIA Spec
[ ] Other __________
[ ] None
Fuel Capacity: __________
Wheel Diameter: [ ] 15"
[ ] 14" [ ] 13"
Front Wheel Width: [ ] 4" [ ] 4.5" [ ] 5" [ ] 5.5"
Rear Wheel Width: [ ] 4" [ ] 4.5" [ ] 5" [ ] 5.5"
Wheel Type: [ ] 48-spoke Dunlop [ ] 60-spoke Borrani [ ] Other __________
Tyre Size: __________ front
__________ rear
Tyre Type: __________
Tyre Wear: __________
Front Windscreen: [ ] Original [ ] Laminated
[ ] Other __________
Side Windows: [ ] Original [ ] Lexan [ ] Other __________
Window Frames: [ ] Original [ ] Removed [ ] Replaced __________
Rear Window:
[ ] Original [ ] Lexan [ ] Other __________
Manifold:
[ ] Original [ ] Replaced __________
[ ] Cast Iron [ ] 4 branch
Silencer(s): [ ] Original [ ] Replaced __________
Exhaust:
[ ] Original [ ] Replaced __________
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