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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 /> Protected Definition Applicable Statutes and <br /> Categories MW FTA Regulations <br /> An individual belonging to Black/African American, Title VI of the Civil Rights <br /> one of the accepted racial Hispanic/Latino, Asian, Act of 1964; <br /> groups; or the perception, American Indian/Alaska 49 CFR Part 21; <br /> based usually on physical Native, Native 49 U.S.C. 5332(b); <br /> characteristics that a Hawaiian/Pacific FTA Circular4702.1B <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 /> NationalOrigin 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 /> Gender Women and Men 49 U.S.C. 5332(b); Title IX <br /> EL of the Education <br /> Amendments of 1972 <br /> • - Persons of any age 21 year old person Age Discrimination Act of <br /> 1975 <br /> Disability 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 /> Complaint Processing <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 /> responsible for the remainder of this process. We will record the transfer of responsibility in our <br /> complaints log). <br />