The document outlines the process for filing a discrimination complaint under Title VI, including necessary information and sections. ​

Section I: Personal Information ​

• Collects name, address, telephone numbers, and email address of the complainant. ​

• Asks about accessible format requirements (e.g., large print, audio tape). ​

Section II: Complaint Representation

• Inquires if the complaint is filed on behalf of oneself or a third party. ​

• Requires confirmation of permission from the aggrieved party if filing for someone else. ​

Section III: Discrimination Details

• Allows the complainant to specify the basis of discrimination (race, color, national origin).

• Requests a detailed explanation of the incident, including names and contact information of involved parties.

Section IV: Previous Complaints ​

• Asks if the complainant has previously filed a discrimination complaint with the agency. ​

• Requests reference information for any prior complaints. ​

Section V: Other Complaints ​

• Inquires if the complaint has been filed with other agencies or courts. ​

• Requests contact information for the agency or court where the complaint was filed. ​

Section VI: Complaint Against Agency ​

• Requires the name of the agency and individual the complaint is against. ​

• Requests additional details such as title, location, and telephone number if available.

• The document concludes with instructions for submission and contact information for the City Recorder.