UTPD Bicycle Maintenance Request After completion of this form, please tag the bicycle if it should be out of service. Date* MM slash DD slash YYYY Time (24 Hour Format)* : Hours Minutes Officer's Name* First Last Email* Shift*Patrol Squad APatrol Squad BPatrol Squad CPatrol Squad DCommunity Relations UnitInvestigationsSpecial EventsStrategic Initiatives UnitTrainingBicycle Number*Please enter a number from 0 to 15.Deficient* Brake (Front) Brake (Rear) Brake Pad (Front) Brake Pad (Rear) Cables (Brake) Cable (Derailleur) Cable (Shifter) Chain Condition Crankset Derailleur (Front) Derailleur (Rear) Equipment Rack Frame Pedal (Left) Pedal (Right) Quick Release (Front Wheel) Quick Release (Rear Wheel) Quick Release (Seat Post) Seat Seat Post Tire Rim/Spokes (Front) Tire Rim/Spokes (Rear) Tire Tread (Front) Tire Tread (Rear) Other Description*Describe the issue or damage. Please also list and describe any attempts to correct the issue.NameThis field is for validation purposes and should be left unchanged. Δ