Monthly Limit Increase Request

Full Name
	last name	first name

Email Address
Phone Number on Uber Account
Age

Address
	Street Address		Appt No
	City	Province	Postal Code

Proof of Residence

Please Upload one of the following: Photocopy of license Photocopy of recent utility bill Municipal tax bill Other official document containing your name and address

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1. Please check the box(es) that best describe you:
I am a high school student
I am a post-secondary student
I work Full Time
I work Part Time
Other (please explain in question 5)


2. How many Innisfil Transit trips do you take in an average month?
0 - 15
16 - 30
31 - 50
51 or more


3. Are you taking extra trips (through the flat fare locations) in order to get to your destination?

noyes

If Yes, please explain why




4. Would your average number of monthly trips have decreased to less than 30 had you taken trips
   directly to and from your destination (i.e. without booking extra trips through the flat fee locations)?
yesno


5. Where are you taking most of your Innisfil Transit trips to/from and for what purpose?
   Please explain your need for an increase beyond the monthly limit of 30 Innisfil Transit trips.



6. Would a limit of 50 direct monthly Innisfil Transit trips to and from your destination be sufficient?
yesno

If no, please explain why and indicate the number of direct monthly Innisfil Transit trips you would need.
(Please Note: the Town will not be approving increases greater than 50 monthly trips at this time, but
will be using this information when considering increases to the monthly trip limit in the future).

Upon receiving this application, the Town will make best efforts to provide a written response to the Applicant
within 3 business days. In assessing the application, the Town may contact the Applicant for further
information. The Town of Innisfil will give special consideration to seniors, students, those who depend on
Innisfil Transit for work and those who face challenging circumstances. The Town will also consider the
Applicant's previous monthly ridership history and the number of direct trips needed by the Applicant to get
to/from their destinations. Applications that are received and approved by the Town before the 10th day of
each month, will be eligible for 50 Innisfil Transit trips in the following month.

Personal information collected on this form is pursuant to the Municipal Freedom of Information and Protection
of Privacy Act, R.S.O. 1990, Chapter M.56, as amended, and will be used to process the application for a
request to increase the monthly limit of Innisfil Transit trips to 50. Information may also be used for
administration and to ensure compliance with the approved increase in Innisfil Transit trips. Information may be
disclosed to Uber for the purpose of implementing the monthly trip limit if approved. Questions about this
collection should be directed to: Clerk's Office, Town of Innisfil, 2101 Innisfil Beach Road, Innisfil ON, L9S
1A1, 705-436-3710 or emailed to clerksoffice@innisfil.ca

By checking this box, the Applicant declares that all information provided is true to the best of their
knowledge. The Applicant further acknowledges that providing any false information on this form may result in
the request being denied. The Applicant also agrees to repay the Town for any Innisfil Transit trips taken
above the approved increase of 50 monthly trips, while also understanding that taking Innisfil Transit to travel
to a flat fare destination should be used solely for the purpose of visiting that location.