DEPARTMENT OF TRANSPORTATION
TITLE VI COMPLAINT FORM

Any person who believes they have been aggrieved by an unlawful discriminatory practice under Title VI has a right to file a formal complaint with Gwinnett County DOT. The complaint must be in writing using this form and must be filed with the Gwinnett DOT Title VI Coordinator within 180 calendar days following the date of the alleged discrimination. The following information is necessary to assist Gwinnett DOT in processing your complaint. Please complete all sections of this form and mail to :

Gwinnett DOT Title VI Coordinator
Gwinnett County Department of Transportation
75 Langley Drive
Lawrenceville, GA 30046

Should you require any assistance in completing this form, please contact the Gwinnett DOT Title VI Coordinator at 770-822-7400.

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