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UTPD Bicycle Maintenance Request

Bicycle Maintenance Checklist

After completion of this form, please tag the bicycle if it should be out of service.
  • Date Format: MM slash DD slash YYYY
  • :
  • Please enter a number less than or equal to 15.
  • Describe the issue or damage. Please also list and describe any attempts to correct the issue.
  • This field is for validation purposes and should be left unchanged.