Huachuca City, AZ · Cochise County
Title VI Complaint Form
This form lets a person who believes they experienced discrimination by the Town or a service provider submit a formal complaint.
What this form is
Use this form to report alleged discrimination by the Town of Huachuca City or one of its service providers based on race, color, or national origin. It asks for your contact information and details about the incident, including its date, location, service, and people involved. You can also indicate whether you filed a complaint with the Federal Transit Administration or previously filed with the agency.
Who needs it
A person who believes the Town or one of its service providers discriminated against them based on race, color, or national origin may file this complaint.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This document is signed and dated without a notary; the signer just signs and dates the form.
How to submit this form
- 1
Download The Form
Download the Title VI Complaint Form.
- 2
Complete The Form
Fill in your contact information, incident details, and responses to the complaint history questions.
- 3
Gather Attachments
You may attach written materials or other information relevant to your complaint.
- 4
Sign And Submit
Sign and date the form, then submit it to the city department named on the form.
Frequently asked questions
- Who can file this Title VI complaint form?
- A person who believes they experienced discrimination by the Town or one of its service providers based on race, color, or national origin may file.
- What information does the form ask for?
- It asks for your contact details and information about the incident, including its date, location, service, people involved, and whether you filed related complaints.
- Do I need a notary for the Title VI Complaint Form?
- No. This form is signed and dated without a notary; the signer just signs and dates it.
- How do I submit the Title VI Complaint Form?
- Submit it to the city department named on the form; check the city website for current contact details.