Passenger Complaint Form/Title VI Complaints

Passenger Service Event Report/Complaint Form
Most of the information in this form is optional. It is optional so that you may remain anonymous if you so desire. We will process anonymous complaints just as we will any other complaint. However, you will not have the benefit of learning the results of our investigation. Additionally, you will not know if there was an error on your part (perhaps in reading a schedule, standing in the wrong spot, etc.). As such, the same problem may occur!

We do not provide the name of the person filing a complaint to the Driver, nor do we alter our investigation in any manner on the basis of the person registering a complaint. So if you can, give us at least one way to reach you to talk about the problem you experienced and give us a better chance to fix it for you!
Thank you for your patronage.
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 Today's Date:
Month:Day:Year:
Name:
First NameLast Name
Your Mailing Address:
Street Address:
City:
State:
Zip:
A Telephone Number where we can reach you between 8:00 am and 5:00 pm:
Telephone:
Your email address:
Email:
This Complaint is being Submitted by:
Internet
Other (enter employee code)
What was the date this incident occured?
Month:Day:Year:
Do you know the Driver's name (partial is OK) who was involved in this incident?
Driver:
Do you know the Fleet Number or License Plate of the bus involved in this incident?
Number:
Where did this incident occur?

On which bus route did this incident occur?

Please tell us what happened, and when and where it happened:


Typically, the Authority will complete its initial investigation within 5 working days. Exceptions might be caused if a key party is on vacation or otherwise unavailable for a short period of time. But if you desire a contact or follow up from this report, please give us your contact information and we will let you know what conclusion we reach. But please be advised, in the case that there was some error or omission on the part of Mountain Line personnel, we can not and will not discuss any action we may or may not have taken when it involves a particular individual. Should the situation involve a company policy or decision, you will be informed of any action deemed necessary to correction any given situation.
Thank you for taking time to complete this report. We really appreciate your help. It is my hope, that by working together, we can offer you the best possible transportation service.
Sincerely,
David Bruffy
 General Manager
 Mountain Line Transit Authority


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