Atwater, CA · Merced County
Title VI Complaint Form (Spanish)
This Spanish-language form lets a person who believes they experienced discrimination in a City of Atwater program, service, or activity submit a complaint.
What this form is
Use this form to report alleged discrimination in a City of Atwater program, service, or activity. The form says complaints must be received within 90 days of the discrimination and asks for contact information, details about the affected person and witnesses, the reason for the complaint, and a description of events and requested corrective action. Attach any documents supporting the complaint.
Who needs it
A person who believes they experienced discrimination in a City of Atwater program, service, or activity can complete and submit this complaint form.
How to submit it
Mail the completed form and any supporting documents to City of Atwater, Attention: Director of Human Resources, 1160 Fifth Street, Atwater, CA 95301.
About notarization
This form is signed and dated without a notary; it requests supporting documents but does not identify any attachment as notarized or sworn.
How to submit this form
- 1
Download the Form
Download the Spanish Title VI Complaint Form PDF.
- 2
Complete the Form
Enter contact details, identify the reason for the complaint, and describe the events and corrective action requested.
- 3
Gather Supporting Documents
Attach any documents you have that support the complaint.
- 4
Mail the Complaint
Mail the form and attachments to the Director of Human Resources at the City of Atwater address listed on the form.
Frequently asked questions
- Who can file this Title VI complaint form?
- Anyone who believes they experienced discrimination in a City of Atwater program, service, or activity can provide the requested information and submit a complaint.
- How do I submit the Title VI complaint form?
- Mail the completed form and any supporting documents to the City of Atwater, Attention: Director of Human Resources, 1160 Fifth Street, Atwater, CA 95301.
- Do I need a notary for the Title VI complaint form?
- No. The form asks for your signature and date, but does not require notarization. It asks you to attach documents supporting the complaint but does not identify any as notarized or sworn.
- What information does the complaint form ask for?
- It asks for contact details for the complainant and affected person, witness information, the reason for the alleged discrimination, an account of events, and requested corrective action.