If you would
like to print a copy of this form to either
mail or fax it to us,
click here.
Or, call Customer Service at 330-47-SARTA
(330-477-2782) to give your information
by phone.
Your concerns
are important to us. Please complete this
form, allowing SARTA to address any issues
you may have.
All information will remain confidential.
SARTA operates its programs and
services without regard to race, color,
national origin, age, gender or disability.
If you feel you have been discriminated
against based on one of the above characteristics,
you have the right to file a complaint.
For more information on your rights, or
to file this type of complaint,
click here.
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This form should be used if you
have a specific concern you'd like to inform
us about.
All fields must be
filled out. |
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Your Name: |
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(First name and last name please.) |
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Address: |
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City: |
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State: |
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Zip:
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Phone:
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(Used to verify details of your submission.)
None |
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E-mail address: |
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(Used to respond to your submission.) |
Description of
bus operator: |
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Male
Female
Unsure
Additional description:
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Route: |
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Bus Number: |
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Big
bus #
Small
bus #
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Exact Date of Incident: |
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(mm/dd/yyyy) |
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Time of Incident: |
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Hour
Minute
AM/PM |
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Exact Location: |
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Street name:
Unsure
Closest landmark/Intersection:
Unsure
Bus stop location:
Unsure |
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Direction of Travel: |
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North
South
East
West
Unknown
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Bus Heading: |
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Inbound
Outbound
Not
sure |
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Comments: |
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Maximum Number
of text characters for this text box is
500.
Do not insert HTML or other code--it will
be rejected.
You have
500 characters
remaining for your comments.
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Do not type here. This box is for SARTA
use. Section is for CSR comments and/or
resolution. |
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