ATLANTA POLICE DEPARTMENT

Division of Taxicabs and Vehicles for Hire

Complaint Form

Case Number:

Complainant’s Information	It is very important we get the address of the LOCATION WHERE the incident occurred.

Name
Telephone Number

Address

City
State
Zip Code

Date(s) of Involved:
Approximate Time:	AM	PM

Incident Involved:	Taxicab	Carriage
Name	Number	Color	Description:
Nature of Complaint:
Overcharge
Driver did not know destination
Improper or Indirect Route
Improper or Hazardous driving
Fare Refusal
Vehicle Condition
Discouraging of a Passenger
Driver Solicited Passenger
Rude or Abusive Passenger
Lost Article
Rude or Abusive Driver
Other (Specify)
Trip Information
Origin of trip/location of incident (if airport, which terminal)?
Destination of trip (Fare paid if any):
What did complainant direct driver to do (If applicable)?
Is the complainant willing to testify at a hearing if necessary?
Yes
No
Additional Comments:
AM
PM
Recorder’s Name
Date Recorded
Time

ADDITIONAL COMMENTS

COMPLAINT STATUS REPORT

INVESTIGATOR’S NAME:
DATE CASE CLOSED:

Form APD 756 9/28/06

ATLANTA POLICE DEPARTMENT

LMahone

2006-09-28

VLivsey

Atlanta Police Department