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How do I fill this out?
Filling out this complaint form requires careful attention to detail. Start by gathering all necessary information and documentation related to your incident. Follow the prompts to ensure you provide all required details before submission.

How to fill out the Civil Rights Complaint Form Submission?
1
Gather all relevant documentation and information.
2
Complete all sections of the complaint form accurately.
3
Include specific details such as dates and times.
4
Add any related correspondence from the transit provider.
5
Email or mail the completed form to the appropriate address.
Who needs the Civil Rights Complaint Form Submission?
1
Individuals who believe they have been discriminated against by a transit provider.
2
Advocates helping others file civil rights complaints with transit agencies.
3
Legal representatives assisting clients in documenting discrimination cases.
4
Organizations focused on civil rights that need to report violations.
5
Transit users seeking to ensure compliance with civil rights standards.
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What are the instructions for submitting this form?
To submit the Civil Rights Complaint Form, complete all required fields and ensure your information is accurate. You can email the completed form to FTACivilRightsCommunications@dot.gov, including 'FTA complaint form' in the subject line. Alternatively, mail the form to the Federal Transit Administration, Office of Civil Rights, Attention: Complaint Team, East Building, 5th Floor - TCR, 1200 New Jersey Avenue, SE, Washington, DC 20590.
What are the important dates for this form in 2024 and 2025?
Important dates for this form in 2024 and 2025 will be specified by the FTA and should be checked for updates regularly. It's advisable to stay informed about submission deadlines or changes in regulations affecting civil rights complaints.

What is the purpose of this form?
The purpose of this form is to provide a standardized method for reporting discrimination by transit providers. It aims to ensure that individuals have a clear process for voicing their concerns. By utilizing this form, the Federal Transit Administration can address and investigate claims of civil rights violations effectively.

Tell me about this form and its components and fields line-by-line.

- 1. Name: The complainant's full name.
- 2. Contact Information: Phone number and email address for communication.
- 3. Basis of Complaint: Categories of discrimination, such as race, disability, etc.
- 4. Incident Details: Specifics about the incident including date, time, and location.
- 5. Supporting Documentation: Space for attaching or mentioning supporting documents.
What happens if I fail to submit this form?
If you fail to submit the form, your complaint will not be received by the FTA. This means your concerns regarding discrimination will remain unaddressed. Consequently, you may miss the opportunity for resolution and potential corrective actions.
- Lack of Documentation: Not submitting may lead to inadequate support for your case.
- Missed Deadlines: Failure to submit on time could affect case evaluations.
- No Response from FTA: Without submission, you will not receive acknowledgment or feedback.
How do I know when to use this form?

- 1. Discrimination Claims: When you face unfair treatment based on protected characteristics.
- 2. Transit Accessibility Issues: If you encounter barriers to using transit services due to disability.
- 3. Failure to Accommodate: When a provider does not provide necessary accommodations.
Frequently Asked Questions
How do I fill out the Civil Rights Complaint Form?
Start by reviewing the form's instructions and gather necessary documents to support your allegations.
What should I include in my complaint?
Include a detailed summary of your allegations and any supporting documentation.
How do I submit the completed form?
You can submit the form via email or mail it to the provided address.
What if I have questions while filling out the form?
You can contact the civil rights hotline for assistance.
Is there a deadline for submitting this form?
There are no specific deadlines mentioned, but it's best to submit as soon as possible.
Can I edit my form after filling it out?
Yes, you can edit your entries using PrintFriendly's PDF editing features.
How do I sign the form?
You can electronically sign the PDF using PrintFriendly’s signing tools.
Is there a way to track my complaint?
After submission, you may contact the FTA for status updates on your complaint.
What happens after I submit my complaint?
Your complaint will be reviewed by the FTA Office of Civil Rights.
Can I save my filled form on PrintFriendly?
You can download your edited PDF for your records after completing it.
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