Adopted: May 1980
Revised: January 2010
Download 707.2.2P - School Bus Stop Arm Violation Report
Violation am
Bus # Date_____________________ Time pm
Location________________________________________________________________________________
Direction of bus___________________________ Direction of violator___________________________________________
Approximate speed of violator: £ 10 mph £ 20 mph £ 30 mph or more
Students crossing in front of bus? £ yes £ no
Violator passed on right side of bus? £ yes £ no
Violator Information
Vehicle: color(s) make model
£ 2-door £ 4-door £ van £ pickup £ other _____
Approximate year_________ License plate #_________________ State __________________________
Driver: £ male £ female Approximate age__________ Hair color
Describe clothing
Other information: ________________________________________________________________________________
District 196 Bus Driver Information
Name Date of birth
(must include middle initial) mm/dd/yy
Home address
Street City Zip Code
Phone numbers (include area code):
Home Cell
Signature of Driver
SCHOOL BUS STOP ARM VIOLATION SYNOPSIS
Draw a description of the incident. If the incident did not occur at a four-way stop, draw it in the blank box. Indicate north and label the street names.
Write a detailed description of the incident. Include the date/time, location, direction of travel, full description of the suspect vehicle and driver, and the location of the students. Attach additional sheets if necessary.