How to File a Discrimination Complaint

Discrimination Complaint Form

Complainant Consent/Release Form

The Alaska Department of Transportation and Public Facilities and its sub-recipients take complaints on the basis of discrimination very seriously. If you feel you have been discriminated against or denied benefits of DOT&PF’s programs and services because of your race, color, national origin, sex, age, & disability or because you have been perceived to belong to any of these groups please complete the Discrimination Complaint Form

How to file a complaint

• Complaint must be in writing
• Signed by the person complaining
• Can be in your native language

1. WHEN You must file within 180 working days of any of the following events:
   • When the act occurred
   • When you found out about it
   • If suspected discrimination was ongoing,
   • Date of last event, or
   • When behavior stopped
2. We will send you a form within 5 working days of getting your complaint.
3. We will need the following information on the form:
• Name, address, phone number, and email (if available).
• Name and address of person or organization who you suspect committed discrimination.
• Basis on complaint:  a) race b) color or c) national origin.
• Date(s) of suspected discriminatory acts in complaint.
• Facts of Complaint: How, Why, Where.
• Names of other agencies, local, state or federal, where a complaint was filed.

You must return the completed form within 15 working days.
The Civil Rights Office will notify the FHWA within 15 days of complaint notification.

4. Send information

TO:

The Civil Rights Office, Department of Transportation & Public Facilities
The State of Alaska
P.O. Box 196900
Anchorage, Alaska 99519-6900
Phone: 907-269-0851
1-800-770-6236 Alaska only
TTY: Contact Relay Alaska 7-1-1
FAX: 907-269-0847
E-mail: dot.titleVI@alaska.gov

and/or
Federal Highway Administration U.S. Department of Transportation Office of Civil Rights 1200 New Jersey Avenue, SE 8th Floor E81-314 Washington, DC 20590	Department of Justice Civil Rights Division Coordination and Review Section-NWB 950 Pennsylvania Avenue, NW Washington, DC 20530

 

• Approved Title VI External Complaint Process