Please complete this form and submit it with receipts within 30 days from the date of the trip. Only trips that are in compliance with the ERH Program Rules are eligible for reimbursement.

Please submit a completed Reimbursement Request form and receipt(s) documenting the emergency ride home to [email protected] or mail all documents to the following address: Transportation Authority of Marin ERH Program, 900 5th Avenue, Suite 100, San Rafael, CA 94901.