Ewing Township Procedimiento de Quejas del Título VI
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1 Ewing Township Senior Citizens Title VI Complaint Procedure Any person who believes she or he has been discriminated against on the basis of race, color, or national origin by Ewing Township Senior Citizens, hereinafter referred to as the Authority, may file a Title VI complaint by completing and submitting the agency s Title VI Complaint Form. Ewing Township Senior Citizens investigates complaints received no more than 180 days after the alleged incident. The Authority will process complaints that are complete. Once the complaint is received, the Authority will review it to determine if our office has jurisdiction. The complainant will receive an acknowledgement letter informing her/him whether the complaint will be investigated by our office. The Authority has (7) seven days to investigate the complaint. If more information is needed to resolve the case, the Authority may contact the complainant. The complainant has (7) seven business days from the date of the letter to send requested information to the investigator assigned to the case. If the investigator is not contacted by the complainant or does not receive the additional information within (7) seven business days, the Authority can administratively close the case. A case can be administratively closed also if the complainant no longer wishes to pursue their case. After the investigator reviews the complaint, she/he will issue one of two 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. An 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 7 (seven) days after the date of the letter or the LOF to do so. A person may also file a complaint directly with the Federal Transit Administration, at FTA Office of Civil Rights, 1200 New Jersey Avenue SE, Washington, DC Ewing Township Procedimiento de Quejas del Título VI Cualquier persona que cree que él o ella ha sido objeto de discriminación por motivos de raza, color u origen nacional Ewing Township Senior Citizens, en lo sucesivo, "la Autoridad," puede presentar una queja del Título VI, completando y enviando el Formulario de Quejas del Título VI de la agencia. Ewing Township Senior Citizens, investiga las quejas recibidas no más de 180 días después del supuesto incidente. La Agencia Estatal de procesar las quejas que se han completado. Una vez recibida la denuncia, la Autoridad revisará para determinar si nuestra oficina tiene jurisdicción. El denunciante recibirá una carta de reconocimiento a él / ella informar si la denuncia será investigada por nuestra oficina. La Autoridad tiene (7) siete días para investigar la denuncia. Si se necesita más información para resolver el caso, la Autoridad podrá ponerse en contacto con el denunciante. El demandante tiene (7) siete días hábiles desde la fecha de la carta para enviar información solicitada al investigador asignado al caso. Si el investigador no está en contacto con el denunciante o no recibe la información adicional dentro de (7) siete días hábiles, la Autoridad puede cerrar administrativamente el caso. Un caso puede ser administrativamente cerrado también si el demandante ya no desea seguir su caso. Después de que el investigador revisa la queja, él / ella emitirá una de las dos cartas al demandante: una carta de cierre o una carta de encontrar (LOF). Una carta cierre resume las acusaciones y afirma que no hubo una violación del Título VI y que el caso se cerrará. Un LOF 1
2 resume los hechos denunciados y las entrevistas sobre el supuesto incidente, y explica si cualquier acción disciplinaria, la formación adicional del funcionario u otra acción ocurrirá. Si el demandante desea apelar la decisión, él / ella tiene (7) siete días después de la fecha de la carta o la LOF para hacerlo. Una persona también puede presentar una queja directamente con Federal Transit Administration, at FTA Office of Civil Rights, 1200 New Jersey Avenue SE, Washington, DC
3 Title VI Complaint Form Note: The following information is needed to assist in processing your complaint. A. Complainant s information: Name: Address: City/State/Zip Code: Telephone Number (Home): Telephone Number (Work): Address: Accessible Format Requirements? (Select One or More) o Large Print o TDD o Audio Tape o Other B. Person discriminated against (if someone other than complainant): Name: Address: City/State/Zip Code: Telephone Number (Home): Telephone Number (Work): Address: Relationship to 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. o Yes o No C. Which of the following best describes the reason you believe the discrimination took place? Race Color National Origin Other: D. On what date(s) did the alleged discrimination take place? Other: 3
4 E. Please describe the alleged discrimination. Explain what happened and whom you believe was responsible. 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 additional space is needed, add a sheet of paper. F. Have you filed this complaint with any other Federal, State, or local agency, or with any Federal or State court? List all that apply. Federal Agency Federal Court State Agency State Court Local Agency If you have checked above, please provide information about a contact person at the agency/court where the complaint was filed. Name: Title: Address: City/State/Zip Code: Telephone Number (Home): Telephone Number (Work): Address: G. Please sign below. You may attach any written materials or other information that you think is relevant to your complaint. Signature Attachments: Yes No Date H. Submit form and any additional information to: Ewing Seniors Ewing Senior & Community Center 999 Lower Ferry Road #204 Ewing, New Jersey Attention: Senior Transportation 4
5 Título VI Formulario de Queja Nota: La siguiente información es necesaria para ayudar en la tramitación de su queja. Información de A. Denunciante: Nombre: Dirección: Ciudad / Estado / Código Postal: Número de teléfono (Inicio): Número de Teléfono (Trabajo): Dirección De Correo Electrónico: Requisitos formato accesible? (Seleccione una o más) o la ampliación de foto o TDD o cinta de audio o Otros B. persona discriminada (si alguien que no sea querellante): Nombre: Dirección: Ciudad / Estado / Código Postal: Número de teléfono (Inicio): Número de Teléfono (Trabajo): Dirección De Correo Electrónico: Relación con la persona a la que se quejan: Por favor, explique por qué usted ha presentado para un tercero: Por favor, confirma que ha obtenido el permiso de la parte perjudicada, si usted está presentando en nombre de un tercero. o Sí o No C. Cuál de las siguientes opciones describe mejor la razón por la que cree que se produjo la discriminación? Race Color Nacional Origen Otros: D. En qué fecha (s) ocurrió la supuesta discriminación ocurrió? 5
6 Otros: E. Por favor, describa la supuesta discriminación. Explique lo que pasó y quien considera que fue responsable. Describir todas las personas que estuvieron involucradas. Incluya el nombre y la información de contacto de la persona (s) que lo discriminó (si se conoce), así como los nombres y la información de los testigos en contacto. Si necesita espacio adicional, agregue una hoja de papel. F. Ha presentado esta queja ante cualquier otro, estatal o agencia local Federal, o con cualquier corte federal o estatal? Listar todos los que aplican. Federal Agency Tribunal Federal Agencia Estatal Tribunal Estatal Agencia Local Si ha comprobado anteriormente, proporcione información acerca de una persona de contacto en la agencia / tribunal donde se presentó la denuncia. Nombre: Título: Dirección: Ciudad / Estado / Código Postal: Número de teléfono (Inicio): Número de teléfono (Inicio): Número de Teléfono (Trabajo): Dirección De Correo Electrónico: G. Por favor firme abajo. Puede adjuntar cualquier material escrito o cualquier otra información que usted piensa que es relevante para su queja. Firma Fecha Adjuntos: Yes No H. Envíe el formulario y cualquier información adicional a: INSERT APROPIADO información de contacto aquí: Ewing Seniors Ewing Senior & Community Center 999 Lower Ferry Road #204 Ewing, New Jersey Attention: Senior Transportation 6
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