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Complaint Form - Transportation
Home\ Complaints \ Transportation Complaint

Please fill out the information requested in this complaint form. Once completed, we will mail or email your complaint number to you along with the information you entered. Please write down your complaint number and keep it in a safe place. You will need it to inquire about the status of your complaint.


Note: * Indicates a required field.

*First Name:   Initial:     *Last Name:  
*Address:
Address 2:
*City:   *State:       *Zip:  
*Phone:
*Email:
If you are a representative for complainant, please fill out this section:
Name:
Phone:
Reason why complainant cannot complete this form:
 
Driver Name:
Driver Badge Number:
Taxi Permit Number:
(from side of cab)
License Tag number:
(if not a taxicab)
Company Name
Date of Incident:
Time of Incident:
Location of Incident:
*Describe your complaint in detail:
 

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