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Title VI / ADA Complaints

Title VI of the 1964 Civil Rights Act requires that “No person in the United States shall, on the grounds of race, color or national origin, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance.”

The Americans with Disabilities Act of 1990 (ADA) prohibits discrimination and ensures equal opportunity for persons with disabilities in employment, State and local government services, public accommodations, commercial facilities, and transportation.

Printable Complaint Form

If you prefer not to submit your complaint online, you may download a paper form instead. Completed paper forms can be mailed or delivered to our office at:

219 E Sycamore St
Kokomo, IN 46901

Title VI / ADA Online Complaint Form

If you feel you have been discriminated against, please provide the following information in order to assist us in processing your complaint. Should you require any assistance in completing this form, please contact us.

Are you filing complaint on your own behalf?

Please confirm that you have obtained the permission of the aggrieved party.

I believe the discrimination experienced was based on (check all that apply):

Explain as clearly as possible what happened and why you believe that discrimination took place. Describe all person who were involved. Include the name and contact info of the person(s) that discriminated against you/other, as well as names contact info of any potential witnesses.

Have you previously filed a Title VI or ADA complaint with this agency?

Have you filed this complaint with any other Federal, State, or local agency, or with any Federal or State Court?

If yes, check all that apply

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