Maryville, IL · Madison County
Title VI Complaint Form
This form lets a person report alleged discrimination involving a Village of Maryville program or activity based on race, color, or national origin.
What this form is
Use this form to report alleged discrimination involving a Village of Maryville program or activity. It asks for the complainant’s contact details, the person affected, the reason and date of the alleged discrimination, and a description of what happened. It also asks whether the complaint was filed elsewhere and provides space for related contact information. The complainant signs and dates the form.
Who needs it
A person who wants to report alleged discrimination involving a Village of Maryville program or activity can complete and return this form.
How to submit it
Complete and return the form to the Village Clerk, Village of Maryville, 2520 North Center Street, Maryville, IL 62062. The form lists 618-345-7028, ext. 6, for assistance.
About notarization
This document is signed without a notary; the complainant signs and dates it, and may attach relevant written materials or other information.
How to submit this form
- 1
Download The Form
Download the Village of Maryville Title VI Complaint Form.
- 2
Complete The Form
Provide the requested contact details, information about the alleged discrimination, and details of any complaint filed elsewhere.
- 3
Gather Attachments
Attach any written materials or other information you think is relevant to your complaint.
- 4
Sign And Submit
Sign and date the form, then return it to the Village Clerk at the address listed on the form.
Frequently asked questions
- What is the Title VI Complaint Form for?
- It allows a person to report alleged discrimination involving a Village of Maryville program or activity and provide information for the village to process the complaint.
- Who can complete this form?
- A person reporting alleged discrimination can complete it. The form asks for the complainant’s information and, if different, information about the person who was discriminated against.
- Do I need a notary for the Title VI Complaint Form?
- No. The complainant signs and dates the form without a notary. Relevant written materials or other information may be attached, but the form does not identify a notarized or sworn attachment.
- How do I submit the Title VI Complaint Form?
- Complete and return it to the Village Clerk, Village of Maryville, 2520 North Center Street, Maryville, IL 62062. The form lists a phone number for assistance.