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Sounder & Link
Compressed Work Week
Emergency Ride Home (ERH) Reimbursement Form
Leave This Blank:
Your worksite must have an agreement with Pierce Transit to use Emergency Ride Home. Reimbursement for UBER or LYFT can only be made if a new Emergency Ride Home (ERH) agreement from 2017 has been filled out and signed.
Click the link to fill out the online agreement.
Emergency Ride Home Reimbursement Request
Reimburse: Full Name
Reimburse: (Home/Work) Address
Reimburse: City, State, and Zip Code
Commuter: Full Name
Commuter: Employer Name
Reason Trip Requested
Check the commute option used the day of ERH
Pickup Address (Street, City, State, Zip Code)?
Intermediate Stop and Address if Needed: (If none write in N/A, otherwise indicate if it's a school, pharmacy, daycare, ATM, etc)
As Program Coordinator, I certify that I approved this Emergency Ride Home and all information submitted is true.
Employee Transportation Coordinator (ETC) Name
FARE AMOUNT ONLY (Not gratuity)
Convert to PDF?
(DOC, DOCX, XLS, XLSX, TXT)
For Pierce Trips Official Use Only
Approved to Pay: Pierce Transit Authorized Signature
* indicates required fields.
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