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Miami-Dade Transit Office of Civil Rights and Labor Relations
ADA Compliance Comments or Concerns

Required fields are marked with an asterisk (*).

I. Contact Information:

Complaint Comment
First Name*
Last Name*
Home Address*
Apt.
City*
State
Zip Code*
Customer Number
Daytime Telephone ex (3055551212)
Evening Telephone ex (3055551212)
E-mail Address


II. Incident Information:


Date of Incident*
,
Time*
:  
Route Number
(If  available)
Bus Number
(If  available)
Date of Complaint *
,
( if different from date of incident)

 

Enter comments and suggestions here:*


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Phonetic spelling (mp3)

Back to Top Page Last Edited: Mon Mar 31, 2014 9:37:08 AM
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