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707.2.2P - School Bus Stop Arm Violation Report

707.2.2P - School Bus Stop Arm Violation Report

Adopted: May 1980
Revised: January 2010


Download 707.2.2P - School Bus Stop Arm Violation Report

Violation                                                                                                      am

Bus #                                      Date_____________________   Time                                                  pm


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


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.