Vehicle Inspection Form for Lyft

VEHICLE INSPECTION REPORT (RIDE-SHARE SERVICE)

INSPECTION DATE: [___________]
INSPECTION LOCATION: [___________]

I. VEHICLE INFORMATION

Owner/Driver Name: [___________]
Make: [___________] | Model: [___________] | Year: [___________]
Vehicle Identification Number (VIN): [_________________________]
License Plate Number: [___________] | State: [___________]
Current Odometer Reading: [___________] miles

II. INSPECTION CHECKLIST

Instructions: The inspector must verify the functionality and condition of each component listed below. Mark (P) for Pass, (F) for Fail, or (N/A) for Not Applicable.

III. INSPECTOR DECLARATION

I, the undersigned, certify that I am a licensed mechanic or authorized inspector. I have performed a physical inspection of the vehicle described above. I certify that the vehicle meets the safety and mechanical standards required for ride-share operation as of the date of inspection.

Inspector Name: [_________________________]
Inspector License/Certification Number: [_________________________]
Facility Name: [_________________________]
Facility Address: [_________________________]

Inspector Signature: ___________________________ Date: [___________]

IV. DRIVER ATTESTATION

I, the undersigned, attest that the information provided herein is true and accurate to the best of my knowledge. I understand that maintaining the vehicle in safe operating condition is my ongoing responsibility while providing services on the Lyft platform.

Driver Signature: ___________________________ Date: [___________]

This document is intended for record-keeping purposes in accordance with ride-share regulatory requirements. Please retain a copy for your personal records.