Reasonable Modification Appeal

Reasonable Modification Appeal Form

In determining whether to grant a requested modification, the Toledo Area Regional Transit Authority (TARTA) will be guided by the provisions of the Americans with Disabilities Act (ADA) as amended and the United States Department of Transportation (DOT) regulations in conjunction with the guidance provided in Appendix E of Title 49 CFR Part 37.

Name of Individual Requesting Modification

First

Last

Name of Passenger Wishing to Utilize Modification

First Name *

Middle Name

Last Name *

Address of Passenger Who Needs Modification

Street Address

Street Address Line 2

City

Zip Code

Primary Phone *

Secondary Phone

Reason for Appeal *

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