5 13 19 title vi non-discrimination complaint form - NJ 2026

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The document is a Title VI Non-Discrimination Complaint Form from the North Jersey Transportation Planning Authority (NJTPA), outlining the process for individuals to file complaints regarding discrimination based on race, color, sex, age, national origin, low income, or disability. It details the rights of complainants, the procedure for filing complaints within specified timeframes, and the investigation process by NJTPA. The form also includes sections for personal information and consent regarding the disclosure of identity during investigations.
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  1. Click ‘Get Form’ to open the 5 13 19 Title VI Non-Discrimination Complaint Form in our editor.
  2. Begin by filling in your personal information, including your name, address, and contact numbers. Ensure accuracy as this information is crucial for communication.
  3. If applicable, provide details about the individual(s) discriminated against. Use additional pages if necessary to include all relevant information.
  4. Specify the agency or program that allegedly discriminated against you. Include names and addresses where possible to facilitate the investigation.
  5. Detail the nature of the discrimination experienced, including specific incidents and any witnesses. This section is vital for a thorough review of your complaint.
  6. Review all entered information for completeness and accuracy before signing and dating the form at the bottom.

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Example 1: [Nonprofit] does not and shall not discriminate on the basis of race, color, religion (creed), gender, gender expression, age, national origin (ancestry), disability, marital status, sexual orientation, or military status, in any of its activities or operations.
It is illegal for an employer to discriminate against an employee in the payment of wages or employee benefits on the bases of race, color, religion, sex (including transgender status, sexual orientation, and pregnancy), national origin, age (40 or older), disability or genetic information.
Title VI, 42 U.S.C. 2000d et seq., was enacted as part of the landmark Civil Rights Act of 1964. It prohibits discrimination on the basis of race, color, and national origin in programs and activities receiving federal financial assistance.
Telephone the 24-hour MVC Tip Line toll-free at 866-TIPS-MVC (1-866-847-7682) to report suspected fraud or criminal behavior that is related to MVC operations.
This means that individuals or groups of individuals which are in comparable situations should not be treated less favourably simply because of a particular characteristic such as their sex, racial or ethnic origin, religion or belief, disability, age or sexual orientation.

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(name of provider) does not discriminate against any person on the basis of race, color, national origin, disability, or age (and any other bases you wish to include) in admission, treatment, or participation in its programs, services and activities, or in employment, or on the basis of sex in its health programs and

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