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ATA Title VI Complaint Form - Civil Rights Act of 1964

image001The Area Transportation Authority of North Central Pennsylvania (ATA) is committed to ensuring that no person is excluded from participation in or denied the benefits of its services on the basis of race, color, or national origin, as provided by Title VI of the Civil Rights Act of 1964, as amended.

If you believe you have been discriminated against, please complete, sign and send this form within 180 days from the date of the alleged discrimination.

You also have the option to complete and forward this ATA Title VI Civil Rights Complaint Form using an interactive PDF found HERE.

If you require any assistance in completing this form, please contact the Title VI Compliance Officer by calling (814) 965-2111.



If yes, please identify agency and address and complaint number (if applicable)

Please use the browse button at the bottom of this form to upload a copy of the complaint form filed. This information is helpful for administrative tracking purposes.

If yes, please complete information below:

Include ALL of the following for each witness:

Witness NAME, FULL STREET ADDRESS, CITY, STATE and ZIP, CONTACT PHONE NUMBER, EMAIL ADDRESS.

Click on the checkbox above if you agree to these terms:

I hereby swear / affirm that the information provided in this complaint form is true and correct to the best of my knowledge, information and belief and I am either the person who feels he / she has been discriminated against or an authorized representative for that person.

IMPORTANT: Please enter the security code correctly below or your information will not be submitted. If you have entered in the correct code and filled in all the required fields on this form you will see a thank you page after clicking on the send button. If you do not see the thank you page your information failed to send. Please try to complete the form again.

If you cannot read the security code below you can click on the button which looks like 2 curvy arrows. You may click on the button as many times as you like until you see a security code you can read.