Fort Lee, MT · Bergen County
Title VI Complaint Form
This form allows a person to report alleged discrimination in a federally assisted program and is filed with the Fort Lee Parking Authority for covered complaints.
What this form is
This form lets a person report alleged discrimination in a program or activity receiving federal financial assistance, including specified transit or grant programs. It asks for complainant and affected-person details, the basis and circumstances of the complaint, and whether it was filed elsewhere. The form directs covered program complaints to the Fort Lee Parking Authority.
Who needs it
A person reporting alleged discrimination in a covered program, or someone reporting it on behalf of another person, can complete this form.
How to submit it
For complaints concerning the Section 5310 Program or other Federal Transit Administration-funded grant programs, return the form to Fort Lee Parking Authority, PO Box 1113, Fort Lee, NJ 07024.
About notarization
This document is signed without a notary; the complainant signs and dates the form, and no notarized or sworn attachment is specified.
How to submit this form
- 1
Download The Form
Download the Title VI Complaint Form PDF.
- 2
Complete The Form
Provide complainant details, information about the person affected, the reason and circumstances, and whether you filed elsewhere.
- 3
Gather Relevant Materials
You may attach written materials or other information relevant to the complaint.
- 4
Submit The Form
For covered program complaints, return the form to Fort Lee Parking Authority, PO Box 1113, Fort Lee, NJ 07024.
Frequently asked questions
- What does the Title VI Complaint Form report?
- It collects information about alleged discrimination in a program or activity receiving federal financial assistance, including the reason, date, location, and circumstances.
- Who should file this form?
- A person who believes they experienced discrimination in a covered program may complete the form. It also asks for details about the person affected if someone else files.
- Do I need a notary for the Title VI Complaint Form?
- No. The complainant signs and dates the form; it does not specify a notarized or sworn attachment.
- How do I submit the Title VI Complaint Form?
- For Section 5310 Program complaints or other Federal Transit Administration-funded grant complaints, return it to Fort Lee Parking Authority, PO Box 1113, Fort Lee, NJ 07024.