GRTA COMPLAINT FORM

DATE & TIME:

DO PARTS I, II and III

PART I – Complainant Info

Clifford “RAYay Hakit 9675377

PART II – Nature of Complaint – Driver on BlueLine1 doing constant retaliation from me telling him to stop running redlights

PART III – Operational Information

Date & time of Incident: 17y5m15d

Service Component: Fixed Route

FOR OFFICIAL USE ONLY

Person Taking complaint:

GRTA ADMIN □

PART IV – Findings/Action

Vehicle Lic.# & Route:

Driver’s Name:

Course of Action Taken

Date & Time Reported to Contractor and

Acknowledgement:

Complaint Forwarded to GRTA Review & AppealsCommittee

CONTROL NO

PART V – Status

Complaint Resolved [ ]