Home/Transportation/Part 37 Regulations

This section contains amendments from September 28, 1998.

Appendix A to Subpart H of Part 37--Service Request Form

Form for Advance Notice Requests and Provision of Equivalent Service

1. Operator's name__________________________________________________________

2. Address________________________________________________________________

_________________________________________________________________________

3. Phone number:____________________________________________________________

4. Passenger's name:__________________________________________________________

5. Address:_________________________________________________________________

__________________________________________________________________________

6. Phone number:____________________________________________________________

7. Scheduled date(s) and time(s) of trip(s):__________________________________________

__________________________________________________________________________

8. Date and time of request:_____________________________________________________

9. Location(s) of need for accessible bus or equivalent service, as applicable:________________

__________________________________________________________________________

10. Was accessible bus or equivalent service, as applicable, provided for trip(s)? Yes ___ No ___

11. Was there a basis recognized by U.S. Department of transportation regulations for not
providing an accessible bus or equivalent service, as applicable, for the trip(s)? Yes ___ No ___

If yes, explain________________________________________________________________

__________________________________________________________________________

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