U.S. Department of Transportation
Federal Highway Administration
1200 New Jersey Avenue, SE
Washington, DC 20590
202-366-4000


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Civil Rights

FHWA » Civil Rights » File

FHWA Office of Civil Rights

Title VI Complaint

The Federal Highway Administration Office of Civil Rights is responsible for ensuring compliance with Title VI of the Civil Rights Act of 1964 by Federal-aid reciepients.

If you have questions about how to prepare a complaint, or to request a hardcopy of this form to submit by U.S. mail, you may contact the FHWA Office of Civil Rights at 202-366-0693 or via email at: FHWA.TitleVIcomplaints@dot.gov

More information about Title VI related civil rights requirements may be found on the FHWA’s website at https://www.fhwa.dot.gov/civilrights/programs/title_vi/

Section I

I believe that I have been (or someone else has been) discriminated against on the basis of:



Section II

 

Section III

Are you filing this complaint on your own behalf?

:

:

Please confirm that you have obtained the permission of the aggrieved party if you are filing on behalf of a third party:

Are you represented by legal counsel for this matter?

If yes, please supply name and contact information:

Have you previously filed a civil rights complaint with FHWA?

Section IV

:

Section V

Have you filed this complaint with any of the following agencies?




Have you filed a lawsuit regarding this complaint?

If yes, please provide the :

Section VI

. FHWA will contact you to request any additional documentation you may want to submit on behalf of your complaint.

Important: We cannot accept your complaint without a signature, so please type your first name.

Page last modified on October 15, 2019
Federal Highway Administration | 1200 New Jersey Avenue, SE | Washington, DC 20590 | 202-366-4000