Request for Professional Verification

  • THESE TWO PAGES MUST BE FILLED OUT BY PROFFESSIONAL North Oakland Transportation Authority (NOTA) requires verification by a professional in order to qualify disabled individuals requesting service for transportation. Please fill in all sections that pertain to the applicant’s disabilities as they relate to using public transportation. If you have any questions, please call (248) 693-7100.
  • 8) Is the applicant able to?
  • I hereby certify that the information given above and in this application is correct.
  • Date Format: MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.