TITLE VI Notice to the Public
The City of Fond du Lac’s Notice to the Public is as follows:
Notifying the Public of Rights Under Title VI
THE CITY OF FOND DU LAC ü The City of Fond du lac operates its programs and services without regard to race, color, and national origin in accordance with Title VI of the Civil Rights Act. Any person who believes she or he has been aggrieved by any unlawful discriminatory practice under Title VI may file a complaint with the City of Fond du Lac. ü For more information on the City of Fond du Lac’s civil rights program, and the procedures to file a complaint, contact 920-322-3433, email the City Clerk at mhefter@fdl.wi.gov.; or visit the City Clerk’s office at 160 S Macy St, Fond du Lac, WI 54935. For more information, visit https://www.fdl.wi.gov/. ü OR A complainant may file a complaint directly with the Federal Transit Administration by filing a complaint with the Office of Civil Rights, Attention: Title VI Program Coordinator, East Building, 5th Floor-TCR, 1200 New Jersey Ave., SE Washington, DC, 20590. |
The City of Fond du Lac’s Notice to the Public is posted in the following locations:
- Agency website (https://www.fdl.wi.gov/)
- Public areas of the agency (office, bulletin boards, located at 530 Doty Street, Fond du Lac, WI 54935)
- Inside vehicles (on all City Transit Fixed Route, Paratransit buses, and Tripper bus)
Title VI Complaint Procedure
The City of Fond du Lac’s Title VI Complaint Procedure is made available in the following locations:
City of Fond du Lac Website www.fdl.wi.gov
Transit central office 530 Doty Street, Fond du Lac, WI 54935
City Clerk’s office, 1st floor 160 S. Macy Street, Fond du Lac, WI 54935
Any person who believes she or he has been discriminated against on the basis of race, color, or national origin by the City of Fond du Lac may file a Title VI complaint by completing and submitting the agency’s Title VI Complaint Form.
Or
A person may file a complaint directly with the Federal Transit Administration, at FTA Office of Civil Rights, 1200 New Jersey Avenue SE, Washington, DC 20590.
All complaints filed with the City shall be received by the City Clerk no less than 180 days from the alleged incident. . The City Clerk will forward to the appropriate City staff for response. All Complaints must be complete, including contact information.
The complainant will receive an acknowledgement letter informing her/him of receipt.
The City’s assigned investigator will have 45 days to investigate the complaint. If more information is needed, the City may request more information from the complainant.
The complainant has 10 business days from the date of the request to respond to the investigator assigned to the case.
If the investigator is not contacted by the complainant or does not receive the additional information within 10 business days, the City can administratively close the case. At any time and in writing, the complainant may withdraw his/her complaint. At this point, the City may close the investigation.
After the investigator reviews the complaint, she/he will issue one of two (2) letters to the complainant: a closure letter or a letter of finding (LOF).
- A closure letter summarizes the allegations and states that there was not a Title VI violation and that the case will be closed.
- A letter of finding (LOF) summarizes the allegations and the interviews regarding the alleged incident, and explains whether any disciplinary action, additional training of the staff member or other action will occur.
If the complainant wishes to appeal the decision, she/he has 10 days after the date of the letter or the LOF to do so. (Where do they file this appeal?)
Title VI Complaint Form
The City of Fond du Lac’s Title VI Complaint Procedure is made available in the following locations:
City of Fond du Lac Website www.fdl.wi.gov
Transit central office 530 Doty Street, Fond du Lac, WI 54935
City Clerk’s office, 1st floor 160 S. Macy Street, Fond du Lac, WI 54935
Section I: | |||||||||||
Name: | |||||||||||
Address: | |||||||||||
Telephone (Home): | Telephone (Work): | ||||||||||
Electronic Mail Address: | |||||||||||
Accessible Format Requirements? | Large Print | Audio Tape | |||||||||
TDD | Other | ||||||||||
Section II: | |||||||||||
Are you filing this complaint on your own behalf? | Yes* | No | |||||||||
*If you answered “yes” to this question, go to Section III. | |||||||||||
If not, please supply the name and relationship of the person for whom you are complaining: | |||||||||||
Please explain why you have filed for a third party: | |||||||||||
Please confirm that you have obtained the permission of the aggrieved party if you are filing on behalf of a third party. | Yes | No | |||||||||
Section III: | |||||||||||
I believe the discrimination I experienced was based on (check all that apply):
[ ] Race [ ] Color [ ] National Origin Date of Alleged Discrimination (Month, Day, Year): __________ Explain as clearly as possible what happened and why you believe you were discriminated against. Describe all persons who were involved. Include the name and contact information of the person(s) who discriminated against you (if known) as well as names and contact information of any witnesses. If more space is needed, please use the back of this form. ______________________________________________________________________________ ______________________________________________________________________________ |
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Section IV | |||||||||||
Have you previously filed a Title VI complaint with this agency? | Yes | No | |||||||||
Section V | |||||||||||
Have you filed this complaint with any other Federal, State, or local agency, or with any Federal or State court?
[ ] Yes [ ] No If yes, check all that apply: [ ] Federal Agency: [ ] Federal Court [ ] State Agency [ ] State Court [ ] Local Agency |
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Please provide information about a contact person at the agency/court where the complaint was filed. | |||||||||||
Name: | |||||||||||
Title: | |||||||||||
Agency: | |||||||||||
Address: | |||||||||||
Telephone: | |||||||||||
Section VI | |||||||||||
Name of agency complaint is against: | |||||||||||
Contact person: | |||||||||||
Title: | |||||||||||
Telephone number: | |||||||||||
You may attach any written materials or other information that you think is relevant to your complaint.
Signature and date required below.
_____________________________________ ________________________
Signature Date
(Please print name __________________________)
Please submit this form in person at the address below, or mail this form to:
City Clerk
City of Fond du Lac
160 S. Macy Street
Fond du Lac, WI 54935