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Civil Rights Office - Affirmative Action Program

Complaint Information

Intake/Referral Form

Pursuant to Tennessee Code Annotated § 10-7-502(a), “all state . . . records . . . shall at all times, during business hours, be open for personal inspection by any citizen of Tennessee, and those in charge of such records shall not refuse such right of inspection to any citizen, unless otherwise provided by state law.” Accordingly, the State cannot and does not guarantee the confidentiality of this document or any notes, files, reports, or other documents, whether created by the State or received from the complainant, accused, or witnesses.

To download the MS Word version, click here or for the Adobe PDF version, click here.

Please forward completed form to:

Director of Affirmative Action
Tennessee Department of Transportation
Civil Rights Office
505 Deaderick Street
Suite 1800
Nashville, TN  37243