CSXT Taxi or Lodging Comment Form
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**INSTRUCTIONS**
PLEASE COMPLETE INFORMATION REQUIRED
AND FAX FORM TO 904-359-1722 OR RNX 322-1722
PLEASE LEAVE A COPY FOR YOUR COMMITTEE MEMBER.
THANK YOU FOR YOUR HELP. PLEASE PRINT LEGIBLY.
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INFORMATION FURNISHED BY:
________________________________________________.
YOUR TELEPHONE NUMBER: BELL PHONE _____/ _____-_______ OR RNX_____-______.
E-MAIL ADDRESS:_____________________________________________________________.
TAXI SERVICE COMMENTS
PICK UP LOCATION:_____________________DROP OFF
LOCATION:_____________________
TAXI COMPANY: ________________________TAXI VEHICLE NUMBER:___________________
TAXI AUTHORITY NUMBER: ______________TAXI ARRIVAL TIME:_______________________
CREW/TRAIN ID: ______________ DATE:_____________ TIME:_____________
DETAILED COMMENTS:
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LODGING COMMENTS
HOTEL/MOTEL
NAME:___________________________________________________________
HOTEL/MOTEL LOCATION:_______________________________________________________
DATE OF INCIDENT:_________________ TIME OF INCIDENT:__________________
ROOM NUMBER(S):_____________________________________________________
CREW/TRAIN ID: ____________________
DETAILED COMMENTS:
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