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Marin Emergency Ride Home Reimbursement Request

Digital Signature Form

  • Please Read First

    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.
  • MM slash DD slash YYYY
  • Max. file size: 50 MB.
  • I AGREE TO THE EMERGENCY RIDE HOME PROGRAM RULES, which is available at https://www.tam.ca.gov/wp-content/uploads/2017/12/Final-ERH-Program-Rules-with-Liabilty-Waiver-and-Assumption-of-Risk-12.12.17.pdf
  • Finally,

    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.
  • This field is for validation purposes and should be left unchanged.

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