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Title VI Complaint Form for Sumter County Transit Division

  1. Section 1
  2. Accessible Format Requirements?
  3. Section 2
  4. If you answered "Yes" to this question, go to Section 3.
  5. Section 3
  6. I believe the discrimination I experienced was based on (check all that apply):
  7. Section 4
  8. Section 5
  9. If yes, check all that apply:
  10. Section 6
  11. By checking the box below and submitting this form, I affirm that I have read the above charge and that it is true to the best of my knowledge, information and belief.*
  12. If information is needed in another language, please contact (352) 689‐4400.
  13. Leave This Blank:

  14. This field is not part of the form submission.