CitiBus Complaint/Incident Form

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Complete this form to submit a complaint to Davenport CitiBus Transit. If you need assistance completing the form, please call 563.888.2151.

All complaints will be reviewed. A response to the alleged incident/complaint submitted will be provided within 15 days if deemed required by staff based on the severity and type of incident/complaint. The complainant must provide a working phone, mailing address, or email address to receive a response.

Davenport CitiBus is committed to ensuring that no person is excluded from participation in or denied the benefits of its services based on race, color, religion, gender, or national origin, as provided by Title VI of the Civil Rights Act of 1964, as amended.

Davenport CitiBus is committed to ensuring that no person is excluded from participation in or denied the benefits of its services based on disability as provided by Title II or Title III of the Americans with Disabilities Act of 1990 (the ADA), the Department of Transportation (DOT) ADA regulations, and Section 504 of the Rehabilitation Act of 1973.

Complaints of discrimination must be filed within 180 days from the date of the alleged discrimination. Following review and investigation, provided correct contact information is submitted, CitiBus Transit will issue one of two letters to the complainant based on findings: a Closure Letter or a Letter of Finding. A Closure Letter will summarize the allegations, state the allegation was unfounded, and provide information on the process to appeal. A Letter of Finding summarizes the allegations, the results of the investigation, and explains whether disciplinary action, additional staff training, or other action will occur.

* Denotes a required field

Complainant Contact Information

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Phone # (Enter 999-999-9999, if N/A)*
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Did someone complete or assist with completion of this form?*
 
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Information about the incident/complaint.

Does your complaint involved alleged discrimination? (Race, Color, National Origin, Disability, Religion, Gender)?*
If Yes, what is the alleged discrimination? If no, use N/A from the dropdown.*
Date and Time of Incident*
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Please describe the alleged incident/complaint. Explain what happened. Provide the names and title of all Davenport employees involved, if available. Provide the names of witnesses, if available.
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Have you filed a complaint with any other federal, state, or local agencies?*
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By clicking submit below, you agree that the information provided in this complaint is true to the best of your knowledge, information, and belief.