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Title VI Discrimination Complaint (Federally Funded Programs)

Federal & State Law Editorial TeamLast reviewed: April 2026

Complaint alleging discrimination based on race, color, or national origin in a program or activity receiving federal financial assistance, in violation of Title VI of the Civil Rights Act.

PDF TemplateUse the instructions below to complete this form

Instructions

File with the federal agency that provides funding to the program (e.g., DOJ, HHS, DOE, DOT). Include the name and address of the federally funded entity, a description of the discriminatory act, the basis of discrimination, and dates. File within 180 days of the last discriminatory act. The agency will investigate and may withhold federal funding from violators. Title VI also covers disparate impact discrimination, not just intentional discrimination.

This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.