Review and Submit
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Complaint ID:
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Incident Information
Incident Date | Origin City | Origin State | Destination City | Destination State | Route/Job/Invoice # |
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Address Type | Address | City | State | Zip | Country |
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Bill of Lading Number (Job #):
Pickup Date:
Delivery Date:
Incident Description
Additional Information
Was at least 48 hours advanced notice provided to the carrier about the need for accessible transportation? |
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Did the bus have an elevated passenger deck above a baggage compartment? |
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Please indicate the type of mobility device being used: |
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Selected Allegations
Contact Information
Name | Email | Phone | Address | |
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Your company information
Company Type: |
Label |
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Company Name: |
Label |
US DOT #: |
Label |
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I am an employee of the reported company:
Privacy Option
Do you authorize FMCSA to disclose the contents of your complaint to the moving company in a notification letter?
Share my complaint [allegations only] with the bus, limousine or motor coach company |
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Include my contact information [name, address, etc.] with the complaint, to the bus, limousine or motorcoach company |
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Share the following portions of my complaint with the reported company:
Allegations only:
Allegations and my name, address, phone number, etc.:
Company Information
Supporting Documents
Certification Statement
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By checking this box, I certify/understand that the statements and information I am submitting in support of this complaint (allegation) are, to the best of my knowledge, true, accurate and complete.