Appendix A - 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
[66 FR 9054, Feb. 6, 2001]