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Braille . <br /> 5 . Discrimination Complaint Form — The Discrimination Complaint Form is consistent with the FTA <br /> Certifications & Assurances, " Nondiscrimination Assurance . " <br /> 6 . Complaint Basis — Allegations must be based on issues involving race , color, national origin , sex, age, <br /> creed ( religion ) or disability . The term " basis " refers to the complainant ' s membership in a protected <br /> group category . <br /> � 8 ! NWEA <br /> � An individual belonging to Black African American % Title V1 of the Civil % Rights <br /> one of the accepted racial Hispanic/ Latino; Asian, Act of 1964 <br /> grcrups , , or the perception, American Indian/Alaska ° 49 CF;R Part 21; <br /> based usuall% y on% physical Nati% ve% , :Native 49 U% . S . C . 5332 ( b ) ; <br /> %characteristics that a Hawaiian % % rcu/Pacific FTA% Cilar 4702 . 1. B <br /> %person is a member of a Islander, White <br /> %racial group <br /> Color of skin , including Black, White, brown , <br /> shade of skin within a racial yellow, etc . <br /> group <br /> Place of birth . Citizenship is Mexican% , Cuban , <br /> not a factor . Discrimination % Japanese, Vietnamese, <br /> based on language or a Chinese <br /> person ' s accent is also <br /> covered. <br /> d Gender Women and Men 49 U . S . C . 5332 ( b ) ; Title IX <br /> of the Education <br /> Amendments of 1972 ' <br /> ® ® Persons of any age 21 year old person Age Discrimination Act of <br /> % 1975 <br /> Physical or mental Blind , alcoholic, para Section 504 of the <br /> impairment, permanent or amputee, epileptic, Rehabilitation <br /> temporary, or perceived . diabetic, arthritic Act of 1973 ; Americans <br /> with Disabilities Act of <br /> 1990 <br /> Religion , Muslim , Christian , Hindu , 49 U . S . C. 5332 ( b ) <br /> Atheist <br /> ComplaintBa rocessi <br /> 1 . When a complaint is received , an Acknowledgment Letter and a Complainant Consent/ Release <br /> Form will be mailed to the complainant within ten ( 10 ) business days by registered mail . <br /> 2 . We will consult with the NCDOT Title VI Program to determine the acceptability and jurisdiction <br /> of all complaints received . ( Note : If NCDOT will investigate , the Title VI Program will be <br /> 15 � Page <br />