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Title VI and ADA Complaint Former 2193
(Rev. 10/17)
Page 1 of 2Mail the signed form to Texas Department of Transportation, Civil Rights Division,
125 East 11th Street, Austin, Texas 78701 or fax to
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How to fill out title vi complaint form
How to fill out title vi complaint form
01
Obtain a copy of the Title VI complaint form from the relevant agency or organization.
02
Fill out all required fields on the form, including your personal information and details of the alleged discrimination or violation of Title VI.
03
Provide any supporting documentation or evidence to strengthen your complaint.
04
Submit the completed form to the designated Title VI coordinator or contact person for review and investigation.
Who needs title vi complaint form?
01
Individuals who believe they have been subjected to discrimination or a violation of their civil rights under Title VI of the Civil Rights Act of 1964.
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What is title vi complaint form?
The Title VI complaint form is a document used to report complaints of discrimination based on race, color, or national origin in programs and activities receiving federal financial assistance.
Who is required to file title vi complaint form?
Any individual or group who believes they have been discriminated against in violation of Title VI may file a complaint, including beneficiaries and potential beneficiaries of federally funded programs.
How to fill out title vi complaint form?
To fill out the Title VI complaint form, you need to provide your contact information, details about the organization involved, a description of the alleged discriminatory act, and any relevant evidence or supporting documentation.
What is the purpose of title vi complaint form?
The purpose of the Title VI complaint form is to allow individuals to report incidents of discrimination and to ensure that those incidents are investigated by the appropriate federal or state agencies.
What information must be reported on title vi complaint form?
The Title VI complaint form must include the complainant's personal information, details of the alleged discrimination, the date and location of the incident, and any witnesses or other relevant information.
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