Jim Hogg County, TX · Jim Hogg County
Title VI Complaint Form
This complaint form lets people report alleged discrimination by the Jim Hogg County Transportation Department based on race, color, or national origin.
At a glance
- Issued by
- City of Jim Hogg County · Jim Hogg County, Jim Hogg County, Texas
- Notarization
- Not required: file this form without a notary.
- Official source
- co.jim-hogg.tx.us
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
The form is included in the county’s Title VI Plan and is for people who believe they experienced discrimination by the Jim Hogg County Transportation Department. It asks for contact details, information about the alleged discrimination, and whether the complaint was filed elsewhere. The plan says complaints must be complete and describes the county’s process for reviewing them.
Who needs it
Anyone who believes the Jim Hogg County Transportation Department discriminated against them based on race, color, or national origin may use this form.
How to submit it
Submit the signed form in person or by mail to Jim Hogg County Transportation Department, 209 N. Oak, Hebbronville, TX 78361.
About notarization
This document is signed and dated without a notary; the complaint form requires the complainant’s signature and date and does not request a sworn statement.
How to submit this form
- 1
Download the Form
Download the Title VI Plan PDF, which includes the complaint form in English and Spanish.
- 2
Complete the Form
Provide your contact details and explain what happened and why you believe discrimination occurred.
- 3
Gather Attachments
Attach any written materials or other information you consider relevant to your complaint.
- 4
Sign and Submit
Sign and date the form, then submit it in person or by mail to the department at 209 N. Oak, Hebbronville, TX 78361.
Frequently asked questions
- Do I need a notary for the Title VI Complaint Form?
- No. The form requires your signature and date, but it does not require notarization or a sworn statement.
- How do I submit the Title VI Complaint Form?
- Submit the signed form in person or by mail to Jim Hogg County Transportation Department, 209 N. Oak, Hebbronville, TX 78361.
- What information does the form ask for?
- It asks for your contact information, details about the alleged discrimination, whether you filed elsewhere, and information about the agency involved. You may attach relevant materials.
- Who can file a Title VI complaint?
- A person who believes they experienced discrimination by the Jim Hogg County Transportation Department based on race, color, or national origin may file.