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Series 707.2.2P - School Bus Stop Arm Violation Report

Adopted: May 1980
Revised: January 2010

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

 

OFFICE USE

Transportation Department

Radio message received at                                                            time

Radio message received by                                                            name

Faxed to PD                    at               

    name          time

 

Police Department Response

Case file #                                          

Citation?                                           

Conviction?                                        

 

 

 

 

 

 

 

 

 

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.

 

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Procedures/707.2.2P/1-7-10