Uber Inspection Form

Uber Inspection Form
Name*
First NameLast Name
Phone Number*
Please enter a valid phone number.
LIGHTS
Satisfied Unsatisfied
Head Lights
Tail Lights
Responsiveness
Turn Indicator Lights
STEERING
Satisfied Unsatisfied
Bushings
Shocks/Springs
Tie Rods
Ball Joints
WINDOWS
Satisfied Unsatisfied
Windows
Windshield
Windshield Wipers
BRAKES
Satisfied Unsatisfied
Right Rear
Left Rear
Right Front
Left Front
Parking Brake
TIRES
Satisfied Unsatisfied
Left Front
Left Rear
Right Front
Right Rear
DON'T FORGET TO CHECK
Satisfied Unsatisfied
Safety Belts
Mirrors
Bumpers
Mufflers
Speedometer
Horn
Doors
Since all the boxes above are chosen as "satisfied", this vehicle passed the inspection.
Since all the boxes above are NOT chosen as "satisfied", this vehicle failed the inspection.
This part must be submitted by the technician.
Information
Vehicle Make
Vehicle Model
Vehicle Year
Licence Plate
VIN #
Technician Name*
First NameLast Name
Phone Number*
Please enter a valid phone number.
Company of Technician*
Technician Signature*
Clear
Please indicate the inspection address.*
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Should be Empty: