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Johnson County 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. Title VI complaints must be filed within 60 days from the date of the alleged discrimination.

The following information is necessary to assist us in processing your complaint. If you require any assistance in completing this form, please contact the Title VI Coordinator by calling 913.715.0561 or by email at [email protected].

Please describe the alleged discrimination incident. Provide the names and titles of Johnson County employees if available. Explain what happened and whom you believe was responsible. Please continue on the next page, and use the back of this form if additional space is required:
If Yes, provide the following agency information

I affirm that I have read the above charge and that it is true to the best of my knowledge, information and belief.

Your rights in Title VI Non‑Discrimination Complaints:

Filing this complaint with the Johnson County Title VI Coordinator does not prevent you from filing a complaint with the Federal Agency providing funding to the party against which a complaint is being lodged. For additional information on location of state and federal offices contact the Title VI Coordinator, [email protected] 913.715.0561.