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Date Recd:Case No. KANSAS DEPARTMENT OF TRANSPORTATION COMPLAINT FORM Name: Address: City & Zip: Cause of Discrimination (check one): o o o race Color National Origin Disability o religion Age Sex
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01
To fill out a PDF Title VI complaint, follow these steps:
02
Open the PDF Title VI complaint form on your computer.
03
Begin by filling out your personal information, including your name, address, phone number, and email address.
04
Provide information about the entity or organization you are filing the complaint against, including their name, address, and contact information.
05
Describe the incident or situation that prompted the complaint. Clearly explain what happened, where it occurred, and when it took place.
06
Specify the individuals or groups involved in the incident and provide their names and contact information, if known.
07
Include any relevant supporting documents or evidence that can help substantiate your complaint. This can include photographs, videos, witness statements, or any other relevant information.
08
Sign and date the complaint form to affirm the accuracy of the information provided.
09
Save a copy of the completed complaint form for your records.
10
Submit the complaint form to the appropriate authority or organization as specified in the instructions.

Who needs pdf title vi complaint?

01
Anyone who believes they have experienced discrimination or been subjected to a violation of Title VI of the Civil Rights Act of 1964 may need to fill out a PDF Title VI complaint. Title VI prohibits discrimination based on race, color, or national origin in programs or activities receiving federal financial assistance. Examples of individuals or groups who may need to file a Title VI complaint include:
02
- Individuals who have been denied access to public transportation services based on their race
03
- Students who have experienced racial harassment or discrimination in educational institutions
04
- Individuals who have been denied language assistance services due to their national origin
05
- Employees who have faced workplace discrimination based on their color
06
Filing a Title VI complaint allows individuals to report and seek resolution for alleged violations of their civil rights.
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A PDF Title VI complaint is a formal document submitted to report discrimination on the basis of race, color, or national origin in programs and activities that receive federal financial assistance, as mandated by Title VI of the Civil Rights Act of 1964.
Any individual or group who believes they have been subjected to discrimination in programs or activities that receive federal funding can file a Title VI complaint.
To fill out a PDF Title VI complaint, one must provide personal information, the nature of the complaint, details about the discriminatory incident, and include relevant evidence or documentation.
The purpose of a PDF Title VI complaint is to ensure that individuals can report and seek redress for discrimination in federally funded programs, thereby promoting equal access and fairness.
The information that must be reported includes the complainant's name and contact information, a detailed description of the alleged discrimination, names of involved parties, and any supporting evidence.
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