Employer-Paid Benefit Option Employee Commuter Choice Survey

This directory contains information about voucher (*) and employer pass programs available in various cities (including the thirty largest transit agencies) throughout the United States. It includes the major transit agencies that offer such programs. However, due to the recent changes in the tax code, more transit agencies will likely begin similar programs. Therefore, do not use this list exclusively to determine whether or not such programs exist. If your city is not listed here, then please contact your local transit agency for information on passes and vouchers that might be available. Many transit agencies are listed on the Web at: [www.fta.dot.gov] or [http://www.apta.com/].

The information below is subject to change without notice and is current as of April 2002.

Employer-Paid Benefit Option Employee Commuter Choice Survey

Our organization is considering offering Commuter Choice, a tax-free benefit program for employees who commute using public transportation. Please complete the questions below concerning your commuting patterns and return to your supervisor by (DATE):_________. 

Name:_________________________

Payroll or Social Security Number: ____________

Office/Department:____________________________ Ext. ______

1. Primary mode of transportation used in your commute to work:

If the answer to #1 was either A. or B., then how many roundtrips per week do you take on public transit or by vanpool? _________

2. If you use public transit, which transit system(s) do you use to commute to work? List all that apply.
____________________________________________________________________________________
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3. What type of fare media do you use while riding public transit? Circle all that apply.

4. On average, how much do you spend per month using public transportation (including vanpools) in your direct commute to work (not including additional stops such as dependent care facilities, shopping, errands, etc.,)? $_________  

5. On average, how many days per month do you use public transportation (including vanpools) in your direct commute to work? _____________ 

6. If you drive to a public transit station, a park and ride lot, or to a vanpool staging area, how much, on average, do you spend on parking at these facilities each month?  $___________  

7. Would you use public transportation if the company offered a "tax-free" Commuter Choice benefit?
�Yes � No 

8. If you were to use public transportation, would any part of your trip include parking at a public transit station, park and ride lot, or vanpool staging area? � Yes� No