Sylvester, GA · Worth County
Title VI Complaint Form
This form lets people report alleged discrimination based on race, color, or national origin to the City of Sylvester.
What this form is
Use this form to report alleged discrimination based on race, color, or national origin. It asks for the complainant’s contact information, details about the incident and any witnesses, and whether complaints have been filed with other agencies or courts. The form also identifies the agency involved and requires the complainant’s signature and date.
Who needs it
A person who believes they experienced discrimination based on race, color, or national origin may complete and submit this complaint form.
How to submit it
Submit the form in person at City of Sylvester, 101 North Main Street, Sylvester, GA 31791, or send it to [email protected], as listed on the form.
About notarization
This form is signed without a notary; the signer just signs and dates it, and no notarized or sworn attachment is mentioned.
How to submit this form
- 1
Download the Form
Download the City of Sylvester Title VI Complaint Form PDF.
- 2
Complete the Form
Provide your contact details and information about the alleged discrimination, including the date and people involved.
- 3
Gather Relevant Materials
Attach any written materials or other information you think is relevant to your complaint.
- 4
Sign and Submit
Sign and date the form, then submit it in person at the listed address or send it to the listed email address.
Frequently asked questions
- Who can use the Title VI Complaint Form?
- A person who believes they experienced discrimination based on race, color, or national origin can use this form to submit a complaint to the City of Sylvester.
- What information does the form ask for?
- It requests contact details, information about the alleged discrimination and involved people, prior complaint details, the agency complained against, and the complainant’s signature and date.
- How do I submit the Title VI Complaint Form?
- The form says to submit it in person at 101 North Main Street, Sylvester, GA 31791, or send it to [email protected].
- Do I need a notary for the Title VI Complaint Form?
- No. The form requires the signer’s signature and date but does not require a notary; it mentions no notarized or sworn attachment.
Need something notarized?
This Title VI Complaint Form doesn’t need a notary — but if you have another Sylvester form that does, a commissioned online notary can help.