Vehicle Inspection Form Lyft Pdf

VEHICLE INSPECTION REPORT FOR LYFT OPERATIONS

INSTRUCTIONS: This form must be completed by a certified mechanic or authorized vehicle inspector. All items must be inspected to ensure compliance with local regulatory requirements and Lyft’s vehicle safety standards.

I. VEHICLE INFORMATION

Owner/Driver Name: ________________________________________________
Vehicle Make: ____________________ Model: ____________________ Year: __________
Vehicle Identification Number (VIN): ________________________________________
License Plate Number: ____________________ State/Province: ________________
Current Odometer Reading: ____________________

II. INSPECTION CHECKLIST

Mark (✓) for Pass, (X) for Fail, or (N/A) for Not Applicable.

III. INSPECTOR DETERMINATION

Result: [ ] PASS (Vehicle meets all safety standards)
Result: [ ] FAIL (Vehicle requires repairs/maintenance)

Summary of Required Repairs (if any):
________________________________________________________________________________
________________________________________________________________________________

IV. CERTIFICATION & SIGNATURES

Inspector Declaration: I, the undersigned, hereby certify that I have conducted a thorough inspection of the vehicle described above. I certify that the information provided herein is accurate and represents the mechanical condition of the vehicle as of the date of inspection.

Inspector Name (Print): ________________________________________
Facility Name/Address: ________________________________________________
Certification/License #: ____________________ Phone: ____________________

Signature of Inspector:

Date: ____/____/20____

Driver Acknowledgment: I acknowledge that I am the owner/operator of the vehicle listed above and that the inspection was performed as required for Lyft platform activation/compliance.

Signature of Driver:

Date: ____/____/20____

CONFIDENTIAL: This document is intended for use by the driver and relevant transportation authorities. Retain a copy for your records.