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Title VI Complaint Form

What is the discrimination based on?
One file only.
100 MB limit.
Allowed types: jpg, jpeg, png, txt, rtf, pdf, doc, docx, mov, mp3, mp4, ogg, wav.

Please sign and date. The complaint will not be accepted if it has not been signed. You may attach any written materials or other supporting information that you think is relevant to your complaint. Please submit the complaint form to the agencies as soon as possible but no more than 180 days after the alleged occurrence.

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The Title VI Complaint form may be submitted directly to the following agencies:

Title VI Coordinator: Robert W. Benstein, A.A.E., Vice President & COO
4100 Capital City Blvd
Lansing, MI 48906

*Within 15 days of receiving the completed form the Title VI Coordinator is required to submit the form to:

Federal Aviation Administration
Office of Civil Rights