WHEELS Para-Taxi Reimbursement Request Form
This form is for requesting reimbursement for taxi fares incurred while using Para-Taxi services. It allows users to describe their trips and submit necessary receipts for processing. Users should complete this form within 90 days from the date of their trip to ensure timely reimbursement.
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How do I fill this out?
To fill out the WHEELS Para-Taxi Reimbursement Request Form, start by entering your personal information at the top of the form. Next, detail your taxi trip by providing the required information in the relevant sections. Finally, ensure you attach the necessary taxi receipts before submission.
How to fill out the WHEELS Para-Taxi Reimbursement Request Form?
1
Enter your personal details including name, address, and contact information.
2
Record the details of your taxi trip, including date, time, origin, and destination.
3
Calculate your fare, tip, and any applicable surcharges.
4
Rate your experience with the taxi service provided.
5
Sign and submit the form along with your taxi receipts.
Who needs the WHEELS Para-Taxi Reimbursement Request Form?
1
Individuals who frequently use taxis and need reimbursement for their trips.
2
People with disabilities requiring wheelchair accessibility for their travel.
3
Caregivers who assist individuals eligible for the Para-Taxi services.
4
Residents of Alameda County looking to offset transportation costs.
5
Anyone needing financial assistance with transport costs to enhance mobility.
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Select the text you want to modify and make your changes.
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What are the instructions for submitting this form?
To submit the completed WHEELS Para-Taxi Reimbursement Request Form, mail it along with your taxi receipts to the Alameda County Transportation Commission at 1362 Rutan Court, Suite 100, Livermore, CA 94551. You can also submit it by fax or via a designated electronic submission portal if available. Always ensure to keep copies of your receipts and forms for your records.
What are the important dates for this form in 2024 and 2025?
For 2024, the forms must be submitted within 90 days after the trip date. Important dates remain consistent with prior years; ensure your requests comply to avoid delays. In 2025, follow the same submission guidelines to facilitate timely reimbursements.
What is the purpose of this form?
The purpose of the WHEELS Para-Taxi Reimbursement Request Form is to allow eligible individuals to receive reimbursement for taxi fares incurred during their eligible trips. This process supports those who rely on taxi services for essential mobility, particularly individuals with disabilities and seniors. By utilizing this form, users can ensure they are fairly compensated for their transportation expenses.
Tell me about this form and its components and fields line-by-line.
- 1. LAST AND FIRST NAME: Field for providing the full name of the passenger.
- 2. ADDRESS: Field for the address where the reimbursement check will be sent.
- 3. Date of Birth: Field for entering the birth date of the applicant.
- 4. Phone Number: Contact number for any follow-up regarding the reimbursement.
- 5. Email: Email address for electronic correspondence.
- 6. TOTAL FARE: Field for recording the total amount charged for the taxi service.
- 7. Surcharge: Field for noting any applicable surcharges related to wheelchair accessible taxi usage.
- 8. Name of Taxi Company: Field to enter the name of the taxi service provider.
What happens if I fail to submit this form?
If you fail to submit the form, you will not be eligible for reimbursement of your taxi fares. Delayed submissions can result in missed opportunities to recover transportation expenses. It is crucial to adhere to the 90-day submission rule to ensure your request is processed.
- Missing Reimbursement: Failure to submit means you won't receive any financial compensation.
- Increased Financial Burden: Without reimbursement, the costs of travel will fall solely on you.
- Disrupted Transportation Access: Not receiving reimbursement may limit your ability to afford necessary travel in the future.
How do I know when to use this form?
- 1. To claim reimbursement: Use this form whenever you wish to recover expenses incurred during taxi rides.
- 2. For travel related to medical appointments: Claim funds back for taxi trips to essential medical services.
- 3. To receive funds for essential errands: This applies for reimbursement when utilizing taxi services for necessary errands.
Frequently Asked Question
How do I download the WHEELS Para-Taxi Reimbursement Request Form?
You can download the form directly from our PDF editor by clicking on the download button after editing.
What information do I need to fill out this document?
You will need your personal details, taxi trip information, total fare, and a signature.
Can I submit this form online?
Yes, you can complete and submit the form electronically through our service.
How do I ensure my reimbursement request is accepted?
Make sure to fill out all required fields and attach original taxi receipts.
What is the maximum reimbursement available?
You can receive up to 85% of the total taxi fare, with a maximum reimbursement of $200 per month.
Is there a time limit for submitting this form?
Yes, all reimbursement requests must be submitted within 90 days of your trip.
What if I can't provide a taxi receipt?
Unfortunately, a taxi receipt is required for all reimbursement requests.
Can I use this form for Uber or Lyft rides?
Yes, you can use this form for TNC services like Uber or Lyft, within the reimbursement guidelines.
Will the reimbursement check be mailed to my address?
Yes, the reimbursement check will be sent to the address provided on the form.
What should I do if I need help filling out the form?
You can contact your local transportation commission for assistance regarding the completion of the form.
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