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U.S. Department of Transportation U.S. Department of Transportation Icon United States Department of Transportation United States Department of Transportation

Title VI Complaint

The Federal Highway Administration Office of Civil Rights is responsible for ensuring compliance with Title VI of the Civil Rights Act of 1964 by Federal-aid reciepients.

If you have questions about how to prepare a complaint, or to request a hardcopy of this form to submit by U.S. mail, you may contact the FHWA Office of Civil Rights at 202-366-0693 or via email at:

More information about Title VI related civil rights requirements may be found on the FHWA’s website at

* Asterisk in the form below denotes required fields

Section I

I believe that I have been (or someone else has been) discriminated against on the basis of

Section II

Section III

Are you filing this complaint on your own behalf?
Please confirm that you have obtained the permission of the aggrieved party if you are filing on behalf of a third party
Have you previously filed a civil rights complaint with FHWA?

Section IV

Section V

Have you filed this complaint with any of the following agencies?
Have you filed a lawsuit regarding this complaint?

Section VI


Important: We cannot accept your complaint without a signature, so please type your first name.