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Fort Bend County Public Transportation Department
ADA Complaint Form
Any person who feels he or she may have been discriminated against is encouraged to report
such a violation to the Fort Bend County Public Transportation Department within 180 days of
the alleged discrimination. You may file a complaint with the Fort Bend County Public
Transportation Department, Attention Civil Rights Officer, 301 Jackson St. Richmond, TX
77469; by telephone (281) 633- RIDE (7433); by fax (832) 471-1843; or by email at
transit@fortbendcountytx.gov. If information is needed in another language, please contact our
office at 281-633-RIDE (7433).
Chinese - 鼓勵任何認為自己受到歧視的人在被指控的歧視之日起180天內向本德縣公共交
通部門舉報此類違法行為。您可以向本德堡縣公共交通部門投訴，民權官員，德克薩斯州
傑克遜街301號，郵政編碼77469；通過電話（281）633-乘車（7433）；傳真（832）471-
1843；或通過電子郵件發送至transit@fortbendcountytx.gov。如果需要其他語言的信息，
請致電281-633-RIDE（7433）與我們的辦公室聯繫。
Arabic –
33).
Vietnamese - Bất kỳ người nào cảm thấy mình có thể bị phân biệt đối xử được khuyến khích báo
cáo hành vi vi phạm đó cho Sở Giao thông Công cộng Quận Fort Bend trong vòng 180 ngày kể
từ ngày bị cáo buộc phân biệt đối xử. Bạn có thể nộp đơn khiếu nại với Sở Giao thông Công
cộng Quận Fort Bend, Cán bộ Quyền công dân Chú ý, 301 Jackson St. Richmond, TX 77469;
qua điện thoại (281) 633- RIDE (7433); qua fax (832) 471-1843; hoặc qua email tại
transit@fortbendcountytx.gov . Nếu cần thông tin bằng ngôn ngữ khác, vui lòng liên hệ với văn
phòng của chúng tôi theo số 281-633-RIDE (7433).
Gujarati - ,
180
.
, , 301 ,
77469 . (281) 633- (7433); (832)
471-1843; transit@fortbendcountytx.gov .
, 281-633- (7433) .
Spanish - Se alienta a cualquier persona que sienta que puede haber sido discriminada a
informar dicha violación al Departamento de Transporte Público del Condado de Fort Bend
dentro de los 180 días posteriores a la supuesta discriminación. Puede presentar una queja ante el
Departamento de Transporte Público del Condado de Fort Bend, Atención al Oficial de Derechos
Civiles, 301 Jackson St. Richmond, TX 77469; por teléfono (281) 633- RIDE (7433); por fax
(832) 471-1843; o por correo electrónico a transit@fortbendcountytx.gov . Si necesita
información en otro idioma, comuníquese con nuestra oficina al 281-633-RIDE (7433).
Hindi -
180
,
, 301 , TX 77469 ;
(281) 633- RIDE (7433); (832) 471-1843; transit@fortbendcountytx.gov
, 281-
633-RIDE (7433)
Malayalam -
180
.
, , 301
,
77469; (281) 633- (7433);
(832) 471-1843; transit@fortbendcountytx.gov .
, 281-633-
(7433) .
Taglog - Ang sinumang tao na sa palagay ay maaaring nadiskrimina siya ay hinihikayat
na iulat ang naturang paglabag sa Kagawaran ng Pampublikong Transportasyon ng
Fort Bend County sa loob ng 180 araw mula sa umano'y diskriminasyon. Maaari kang
maghain ng reklamo sa Kagawaran ng Pampublikong Transportasyon ng Fort Bend
County, Attention Civil Rights Officer, 301 Jackson St. Richmond, TX 77469; sa
pamamagitan ng telepono (281) 633- RIDE (7433); sa pamamagitan ng fax (832) 471-
1843; O sa pamamagitan ng email sa transit@fortbendcountytx.gov. Kung kailangan ng
impormasyon sa ibang wika, mangyaring makipag-ugnay sa aming tanggapan sa 281-
633-RIDE (7433).
Urdu -
Fort Bend County Public Transportation Department
ADA Complaint Form
Fort Bend County is committed to a policy of non-discrimination in the conduct of its business, including
Title II of the Americans with Disabilities Act of 1990 that no entity shall discriminate against an
individual with a disability in connection with the provision of transportation service. The law sets forth
specific requirements for vehicle and facility accessibility and the provision of service. The Public
Transportation Department recognizes its responsibilities to the Fort Bend County community in which it
operates and to the society, it serves. The Public Transportation Department will utilize its best efforts to
ensure that no person shall, on the grounds of disability, be excluded from participation in, be denied the
benefits of, or be subjected to discrimination under the Fort Bend County program of transit service
delivery and related benefits.
Any person who feels he or she may have been discriminated against is encouraged to report such a
violation to the Fort Bend County Public Transportation Department within 180 days of the alleged
discrimination.
The following information is necessary to assist us in processing your complaint. Should you require
any assistance in completing this form, or if information is needed in another language, please let us
know by telephone (281) 633-7433 or by email at Transit@co.fort-bend.tx.us. Complete and return
this form to Fort Bend County Public Transportation Department, Attention Civil Rights Officer, 301
Jackson Street, Richmond Texas 77469.
1.Complainant’s Name ________________________________________________
2.Address___________________________________________________________
3.City, State and Zip Code______________________________________________
4.Telephone Number______________________(alternate)____________________
5.Email Address______________________________________________________
6.Person discriminated against (if someone other than the complainant)
Name_____________________________________________________________
Address___________________________________________________________
City, State and Zip Code______________________________________________
Please explain your relationship to this person ____________________________
7.Which of the following best describes the reason you believe the discrimination tookplace? Was it
because of your:
a.Race/Color/Ethnicity_____________
b.National Origin __________
c. Low Income______________
d. Limited English______________
8. What date did the alleged discrimination take place.____________________
9. In our own words, describe the alleged discrimination. Explain what happened and whom you
believe was responsible. Please use the back of this form if additional space is required.
If you need additional space, an additional sheet is attached for that purpose.
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10. 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
11. Please provide information about a contact person at the agency/court where the complaint was
filed if applicable.
Name ____________________________________________________________
Address __________________________________________________________
City, State, and Zip Code _____________________________________________
Telephone Number _________________________________________________
Please sign below. You may attach any written materials or other information that you think is
relevant to your complaint.
_____________________________
Complainant’s Signature Date
Additional space if needed.
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