Lyft Inspection Form
Vehicle Information
Fill in the information below.
Rows
Satisfied
Unsatisfied
Right front brake
1
2
Right rear brake
3
4
Left front brake
5
6
Left rear brake
7
8
Parking brake
9
10
Ball joints
11
12
Tie rods
13
14
Bushing
15
16
Rack and pinion
17
18
Windshield
19
20
Turn Indicator Lights
21
22
Stop Lights
23
24
Doors
25
26
Speedometer
27
28
Bumpers
29
30
Muffler
31
32
Left front tire
33
34
Left rear tire
35
36
Right front tire
37
38
Right rear tire
39
40
Seat adjustments in the front
41
42
Mirrors
43
44
Seatbelts
45
46
Head lights
47
48
Tail lights
49
50
Inspection Status
If all the boxes above are chosen as "satisfied", then please choose "passed". Otherwise, please choose failed.
*
Passed
Failed
Inspector Name
*
First Name
Last Name
The company of the Inspector
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Inspection Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Signed
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Signature
*
Driver Information
Driver Name
*
First Name
Last Name
License Plate
*
VIN #
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Vehicle Make/Model
*
Vehicle Year
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Driver Signature
*
Date of Signed
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Should be Empty: