Submit a request – East Yorkshire

Your email address

Subject

Contact Reason

Complaint(optional)

Title

First name

Surname

Address(optional)

Postcode(optional)

Contact telephone number(optional)

Date of incident(optional)

Time of incident(optional)

Route/Service number(optional)

What time did you board the bus?(optional)

Where did the incident happen?(optional)

Was it a single or double decker bus?(optional)

Colour of bus(optional)

Where did you board the bus?(optional)

Where did you get off the bus?(optional)

Outline of incident(optional)

How has this incident affected you?(optional)

Did you report the incident to the driver?(optional)

Driver number(optional)

Driver description(optional)

Date of accident(optional)

Time of accident(optional)

Accident location(optional)

Route number(optional)

Bus Registration number(optional)

Bus fleet number(optional)

Was it a single/double decker bus?(optional)

Bus colour(optional)

Which direction was the bus travelling in?(optional)

Which direction was the vehicle travelling in?(optional)

Make/Model/Colour of vehicle(optional)

Registration number of the vehicle(optional)

Details of damage sustained to vehicle?(optional)

Description of what happened(optional)

Which part of the bus made contact with the vehicle?(optional)

Do you have photos of the damage?(optional)

If yes, please attach photos on submission

If our driver hasn't stopped, has the collision been reported to the police?(optional)

If yes, please provide Police log number

Police Log number(optional)

Driver name/number(optional)

Description of driver(optional)

Lost Item(optional)

Description of the lost item (optional)

Service Number(optional)

Direction of travel(optional)

Where were you sat?(optional)

Date of journey(optional)

Details of travel requirements(optional)

Reason for suggestion(optional)

Journey details(optional)

Travel Pass type(optional)

Ticket purchased(optional)

Outline of issue with ticket(optional)

Email address used for app ticket(optional)

School/College (optional)

Ticket/Pass purchased(optional)

Verfication required(optional)

Email address used for student ticket(optional)

Type of Concessonary Pass(optional)

Issuing Council(optional)

Time of journey(optional)

Where are you travelling from?(optional)

Where are you travelling to?(optional)

What direction is the bus going to?(optional)

Description of bus e.g single/double deck(optional)

Description of driver - do you have the driver number?(optional)

Did you buy a ticket on the bus?(optional)

Description

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Attachments(optional)

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