Title VI Complaint Form
Phoenix Sky Harbor International Airport, Phoenix Deer Valley Airport and Phoenix Goodyear Airport 
Fields marked with an asterisk(*) and shown in bold are required.

The City of Phoenix Aviation Department 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. Additionally, 49 U.S.C. § 47123 prohibits recipients of U.S. Department of Transportation financial assistance from engaging in discrimination based on sex, creed or religion. Title VI complaints must be filed within 180 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 Program Manager by calling (602) 273-4062 or e-mailing PHXCivilRights@phoenix.gov. You may also download and complete this form in a PDF version.

Personal Information:
*Your Name *Phone
Alt. Phone *Street Address
*City *State
*Country *ZipCode
Person(s) discriminated against (if someone other than complainant):
Name(s) Street Address
City State
Country ZipCode
Incident Description:
*Which of the following best describes the reason for the alleged discrimination?
*Date of Incident
Time of Incident
*Please describe in detail the alleged discrimination and the names of those responsible.
Additional Information:
*Have you filed a complaint with any other federal, state or local agencies?
*If you answered “yes,” please provide the following information:
Agency Contact Name
Phone Street Address
City State
Country ZipCode
Agency Contact Name
Phone Street Address
City State
Country ZipCode

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Mailing Address: Title VI Program Manager, 3400 E. Sky Harbor Boulevard Suite #3300, Phoenix, AZ 85034

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