ADA Complaint Civil Rights Complaint FormPlease describe your complaint. You should include specific details such as names, dates, times, route numbers, witnesses, and any other information that would assist us in our investigation of your allegations. Please also provide any other documentation that is relevant to this complaint, including any related correspondence from Muncie Indiana Transit System.Section ISection I: I believe that I have been (or someone else has been discriminated against on the basis of: Race / Color / National Origin Disability Not Applicable I believe that Muncie Indiana Transit System has failed to comply with the following program requirements Americans With Disabilities (ADA) Not Applicable Section IIName:*Street Address:*City*StateZip CodeHome Phone NumberCell Phone NumberE-Mail Address Accessible format requirements Large Print Not Applicable Other Section IIIAre you filling this complaint on your own behalf?* Yes No [If you answered "yes" to this question, go to Section IV.]If not, please supply the name and the relationship of the person for whom you are complaining:Person Complaint relationshipPlease explain why you have filed for a third party:why third partyPlease confirm that you have obtained the permission of the aggrieved part if you are filing on behalf of a third party: Yes No Section IVWhat was the nature of your complaint?Have you previously filed a civil rights complaint with MITS? Yes No Section VPlease provide a description of your current complaint below.Consent* The information above is correct to the best of my knowledgeName* First Last Date* MM slash DD slash YYYY CAPTCHA Δ