Bike Patrol Bicycle Maintenance Request

2. Watauga Police Department

   Bike Patrol Maintenance Request

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6. Date:*

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9. Bike #:*
   -- Select One --123456Other

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13. Problem with bicycle:

    (Please be detailed as to what is wrong with the bicycle and/or bicycle equipment)

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17. What happened? (here you can describe what happened when the part failed, or if you found it that way when you went to start your shift)

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21. Officer submitting maintenance request:

23. Name of Officer submitting maintenance request:*
    -- Select One --BabcockCareyDykesGochalHickmanHonardarLetartLittleMeadMullerParhamRifeStrubeTeichelman

Leave This Blank:


25. 1. Receive an email copy of this form.
26. Email address

    This field is not part of the form submission.

27. Submit Submit and Print