civil rights discrimination complaint form package

Complaint for Violation of Civil Rights (Non-Prisoner) Download Form (docx, 45.56 KB) Download Form (pdf, 1.01 MB) Form Number: Pro Se 15. Details. DISCRIMINATION COMPLAINT FORM You do not have to use this form to file a complaint with the U.S. Department of Education’s Office for Civil Rights (OCR). PDF; Size: 144 KB. Complainant Information. You may file a discrimination complaint with CDSS by e-mail, writing or calling: California Department of Social Services Civil Rights 744 P Street, M.S. If you wish to file a complaint with CRCL, please download the fillable complaint form and e-mail, fax, or mail the completed form back to CRCL; if you wish to file a complaint with CRCL without using the optional complaint form, please provide a detailed written description of the pertinent events via email, fax, phone, or postal mail. If you believe your civil rights, or someone else’s, have been violated, submit a report using our online form… Suite 515F, HHH Building . September 2010. DISCRIMINATION COMPLAINT FORM You do not have to use this form to file a complaint with the U.S. Department of Education’s Office for Civil Rights (OCR). Centralized Case Management Operations 200 Independence Ave., S.W. You will be charged filing costs and service costs when the complaint is filed at the district court. We collected information about Office Civil Rights Discrimination Complaint Form for you. For information on the discrimination complaint process, contact the Office of the Assistant Secretary for Civil Rights, Information Research Service, on (202) 260-1026 or (866) 632-9992 (toll free) or send an email to the Office of the Assistant Secretary for Civil Rights at CR-INFO@usda.gov. Complete the Complaint Verification Form and the Identity Release Statement and submit to: Office for Civil Rights Office of Justice Programs U.S. Department of Justice 810 Seventh Street NW Washington, DC 20531 Be careful to change the information the form asks for to fit the facts and circumstances of your case. September 2010. information identified in the enclosed Civil Rights Compliance Information Request Package. There are links where you can find everything you need to know about Office Civil Rights Discrimination Complaint Form. _ _ _ _ _ _ _ If you believe discrimination is occurring in any of MDT’s programs or services, please contact: MDT Office of Civil Rights 2701 Prospect Avenue, PO BOX 201001 Helena, MT 59620-1001 If no, please proceed to question3. Introduction. The USDA’s Office of the Assistant Secretary for Civil Rights requests this information pursuant to 7 CFR Part 15. For information on how to file a complaint regarding these groups, please feel free to contact the Department of Civil Rights, Equal Opportunities Division, during business hours, Monday – Friday, 8:00 am – 4:30 pm at (608) 266-4910. The Office for Civil Rights (OCR) enforces five federal civil rights laws that prohibit discrimination on the basis of race, color, national origin, sex, disability and age in programs or activities that receive federal financial assistance Complainant Information. If someone has violated your civil rights, there are several methods available for you to file a complaint and see that action is taken against the violator. For communications under: Optional Protocol to the International Covenant on Civil and Political Rights; Convention against Torture, International Convention on the Elimination of Racial Discrimination or; Convention on the Rights of Persons with Disabilities; Please indicate which of the above procedures you are invoking Some of the forms, such as the form for a generic complaint, apply to different types of cases. Note: The civil complaint form is for use in filing small claims. If you believe you have been the victim of unlawful discrimination within the past 180 days, you can file a complaint online or by calling 1-800-482-3604.. The Iowa Civil Rights Act prohibits "discriminatory practices." Fax: (512) 463-2643 (Please include a cover sheet with your name and the total # of pages included.) CIVIL RIGHTS DISCRIMINATION COMPLAINT FORM 1. BASIS (For each claim you believe was discriminatory, list the bases for your complaint) (You may list one or more): OMB Number 2900-0662 Estimated burden: 15 minutes. To request a copy of the complaint form, call (866) 632-9992. This form is also for use by tenants when filing complaints about landlords. Law Society Of Scotland Complaints Commission, Senior Health Insurance Company Pennsylvania Complaints, Gauteng Rental Housing Tribunal Complaints, Complaints Against American Consumer Credit Counseling, Describe What Is Involved In Responding To A Customer Complaint, Filing A Complaint Against A Texas State Legislator. The information goes directly to an investigator at the Minnesota Department of Human Rights. Please note: Filing out this form does not mean you filed a charge of discrimination. Details. Others apply only to specific types of cases. If you wish to file a complaint with CRCL, please download the fillable complaint form and e-mail, fax, or mail the completed form back to CRCL; if you wish to file a complaint with CRCL without using the optional complaint form, please provide a detailed written description of the pertinent events via email, fax, phone, or postal mail. Discrimination Complaint Instructions and Form | Español | Kreyòl Download and print the Complaint Instructions and Form. Whistleblower Law for State of Wisconsin Employees Complaint Form ERD-13859 [Filing Time Limit - 60 Days] Retaliation under the Fair Employment Law Form ERD-18359 [Filing Time Limit - 300 days] Complaint Withdrawal. 5) Mail or deliver the complaint form to: Skagit Transit - Civil Rights Coordinator - 600 County Shop Lane - Burlington, WA 98233- 9772. BoxAre you making this complaint on behalf of a student? Return signed form, including additional pages or documents, to: Attn: Chief Administrative ADA District Attorney's Office Justice Center 701 N. Columbia Street. necessary, to your complaint. Department of Justice, is charged with enforcing the federal civil rights laws throughout the Northern District of California. The Civil Rights Division enforces federal laws that protect you from discrimination based on your race, color, national origin, disability status, sex, religion, familial status, or loss of other constitutional rights. Student Complaint Form For Discrimination. To request a copy of the complaint form, call (866) 632-9992. 800-628-6580 – toll free By Mail: Indiana Civil Rights Commission Suite 515F, HHH Building Washington, D.C. 20201 ... Our civil rights were mandated to help us achieve equality. To submit a complaint, please type or print, sign, and return completed complaint form package (including consent form) to the OCR Headquarters address below. Return the completed complaint form to the Division. 3. EMPLOYMENT DISCRIMINATION COMPLAINT FORM. Centralized Case Management Operations 200 Independence Ave., S.W. Submit your completed form by mail, email, or fax to: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights Please return this form by: Mail: 101 East 15th Street, #144T, Austin, TX 78778-0001. Once this form is received by the Corporate Integrity Program Office, you will COMPLAINT. discrimination. To find needed information please click on the links to visit sites with more detailed data. information requested in the form to which this Notice is attached. To submit a complaint, please type or print, sign, and return completed complaint form package (including consent form) to the OCR Headquarters address below. 8-16-70 Sacramento, CA 95814 Call: (916) 654-2107 E-Mail: crb@dss.ca.gov DISCRIMINATION COMPLAINT FORM You do not have to use this form to file a complaint with the U.S. Department of Education’s Office for Civil Rights (OCR). There are links where you can find everything you need to know about Office For Civil Rights Discrimination Complaint Form. Mail or Fax your completed complaint form along with any supporting documentation to the following: Civil Rights Coordinator, Civil Division United States Attorney’s Office, District of Western Washington 700 Stewart Street, Suite 5220 Seattle, WA 98101 (206) 553-4073 (fax) If you need assistance completing this form contact the Civil Rights Officer at 408-364-4005. 4) The Complainant, or his/her representative, must sign the form. DISCRIMINATION COMPLAINT FORM You do not have to use this form to file a complaint with the U.S. Department of Education’s Office for Civil Rights (OCR). qcc.edu. The USDA Program Discrimination Complaint Form, can be found online at: https://www.ocio.usda.gov/document/ad-3027, or at any USDA office. Civil Rights Discrimination BASIS OF COMPLAINT: (Mark all that apply) Complaint Form MDT attempts to provide accommodations for any known disability that may interfere with a person participating in any service, program, or activity of the Department. The Bill of Rights to the Constitution, as well as numerous federal and state laws, protect your civil rights and protect you from being discriminated against on the basis of traits such as gender, race, or religion. Whistleblower Law for State of Wisconsin Employees Complaint Form ERD-13859 [Filing Time Limit - 60 Days] Retaliation under the Fair Employment Law Form ERD-18359 [Filing Time Limit - 300 days] Complaint Withdrawal. Someone from the Office of Civil Rights will be in contact with you within 7 business days of receiving the complaint. You can file a complaint by using the Client Complaint of Discrimination form. Use of a form is not required for a person filing a complaint. Individuals who believe they are victims of discrimination should submit a Civil Rights Intake Questionnaire to the Arizona Attorney General's Office. If no, please proceed to question3. 6) Within five days of receipt of the complaint, the … To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: How to File a Complaint, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. If no, please proceed to question3. PDF; Size: 691 KB. Washington, D.C. 20201 2a. If you have questions about civil rights or believe you have been discriminated against, contact MDCR by phone (1-800-482-3604), in writing, online or in person. calstate.edu. The Office for Civil Rights (OCR) enforces five federal civil rights laws that prohibit discrimination on the basis of race, color, national origin, sex, disability and age in programs or activities that receive federal financial assistance If you believe discrimination is occurring in any of MT DOJ’s programs or services, please contact: MDOJ Central Services Division ATTN: HR Manager 840 Helena Avenue, PO Box 201404 . Email: EEOIntake@twc.state.tx.us . You may send OCR a letter or e-mail instead of this form, but the letter or e-mail must include the information … File a Civil Rights Complaint. The Iowa Civil Rights Act prohibits discrimination in 5 areas. Complaints of discrimination may be written or verbal. Office of the Assistant Secretary for Civil Rights (USDA) requests this information pursuant to 7 CFR Part 15. Our Discrimination Complaint Procedures | Español | Kreyòl Review the Discrimination Complaint Procedures. The . § 1324b(a)(1), that the Department of Justice’s Civil Rights Division enforces. If you believe you are a victim of unlawful discrimination, the first step to filing a complaint is to initiate an online inquiry using the form below. Yes No If yes, please answer questions 2a and 2b. Be careful to use the form that fits your case and the type of pleading you want to file. Name Address Apt # City, State, Zip Code Telephone Number: (day) (evening) _ Date of Birth Best time to reach you: Day Evening 2. The Department will review the information you submitted and determine if the reported incident is covered under the Minnesota Human Rights Act. qcc.edu. Step 1 – Contact MDCR. The United States Attorney’s Office (USAO), in coordination with the Civil Rights Division of the United States. Office for Civil Rights . Affirmative Action Discrimination Complaint Form. Introduction. We collected information about Office For Civil Rights Discrimination Complaint Form for you. If you believe that a covered entity discriminated against you or violated your (or someone else's) civil rights on the basis of your race, color, national origin, disability, age, or sex, you may file a complaint with the Office for Civil Rights (OCR). Office for Civil Rights. The HHSC Civil Rights Office must receive the complaint of discrimination within 180 days of the date the alleged discriminatory action took place. If you select the fillable PDF complaint form, once you complete the complaint form and Consent Form, you should print them out, sign them; and mail them (or email scanned copies of the signed forms) to the Enforcement Office with authority for the state where the institution or entity you are complaining about is located. Director will forward to Food and Nutrition Services, Western Regional Office, San Francisco. Model Complaint Form. To file a Public Civil Rights complaint, complete the following form sections and mail or fax it to the CSHS Corporate Integrity Program Office at 8700 Beverly Blvd, Los Angeles, CA 90048, or fax to (323) 866-7871. PDF; Size: 144 KB. Texas Workforce Commission Civil Rights Division. File Format. The complaint must be filed within 300 days of the alleged discriminatory practice. Alternative accessible formats (e.g. BoxAre you making this complaint on behalf of a student? Submit your completed form or letter to USDA by: (1) mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: program.intake@usda.gov. of this document Our offices remain open to the public, but due to the Coronavirus (COVID-19) public health emergency, we encourage you to contact our office by phone or email whenever possible. Texas Workforce Commission Civil Rights Division. The Attorney General’s Office is committed to protecting Arizona and its citizens. If the CRTC has jurisdiction then an investigation will be conducted. U.S. Department of Health and Human Services . BoxAre you making this complaint on behalf of a student? To mail, email or fax a complaint, please complete the form and the attached Complaint Consent Form send it to the attention of Uplift Family Services, Civil Rights Officer. or. File Format. Telephone: (888) 452-4778 . Fax: (512) 463-2643 (Please include a cover sheet with your name and the total # of pages included.) Office of the Assistant Secretary for Civil Rights USDA Program Discrimination Complaint Form Instructions (The complaint form is below the instructions) PURPOSE: The purpose of this form is to assist you in filing a USDA program discrimination complaint. VA FORM NOV 2005. PDF; Size: 691 KB. If you believe your civil rights, or someone else’s, have been violated, submit a report using our online form… The CRTC will determine if it has jurisdiction within 10 working days. You may return the complaint by postal mail to the regional office nearest you, email your complaint to [email protected], or fax it to (718) 741-8322. CIVIL RIGHTS DISCRIMINATION COMPLAINT USE AN ADDITIONAL SHEET OF PAPER TO ANSWER ANY QUESTION IF NECESSARY. To withdraw a Civil Rights complaint file the Request to Withdraw Complaint form (ERD-4971-E) For more information. You also can file a complaint in person or by letter, email, fax or phone: HHSC Civil Rights … File Format. Services (HHS) for purposes associated with civil rights compliance and as permitted by law. For help filling out the form… How To File a Complaint with the Civil Rights Center. If you believe you have been discriminated against by a program financed by the Department of Labor and you wish to file a complaint. You may send OCR a letter or e-mail instead of this form, but the letter or e-mail must include the information in … How to File a Discrimination Complaint With the Office for Civil Rights. Student Complaint Form For Discrimination. The USDA Program Discrimination Complaint Form, can be found online at: https://www.ocio.usda.gov/document/ad-3027, or at any USDA office. calstate.edu. large print, audio cassettes, etc.) Office for Civil Rights . You will be charged filing costs and service costs when the complaint is filed at the district court. How to File a Discrimination Complaint With the Office for Civil Rights. To request a copy of the complaint form, call (866) 632-9992. 10-0381. Please return this form by: Mail: 101 East 15th Street, #144T, Austin, TX 78778-0001. Note: The civil complaint form is for use in filing small claims. According to the lawsuit, and based on the department’s nearly two-year investigation, Facebook’s discrimination against U.S. workers was intentional, widespread, and in violation of a provision of the Immigration and Nationality Act (INA), 8 U.S.C. The Civil Rights Division enforces federal laws that protect you from discrimination based on your race, color, national origin, disability status, sex, religion, familial status, or loss of other constitutional rights. Email: EEOIntake@twc.state.tx.us . If you need assistance filling out the form, you may call any of the telephone numbers listed at the bottom of the complaint form. Complainant Information. Download. To request a copy of the complaint form, call (866) 632-9992. The USDA’s Office of the Assistant Secretary for Civil Rights requests this information pursuant to 7 CFR Part 15. You will need one copy of the civil complaint with original signature for the magisterial district judge. If you believe you are a victim of unlawful discrimination, the first step to filing a complaint is to initiate an online inquiry using the form below. EMPLOYMENT DISCRIMINATION COMPLAINT FORM. Affirmative Action Discrimination Complaint Form. CIVIL RIGHTS DISCRIMINATION COMPLAINT FORM 1. This form is also for use by tenants when filing complaints about landlords. We therefore or. Any person who believes that they have been discriminated against in violation of the Iowa Civil Rights Act may file with the ICRC. Name Address Apt # City, State, Zip Code Telephone Number: (day) (evening) _ Date of Birth Best time to reach you: Day Evening 2. Welcome to the OCR Complaint Assessment System This section of the OCR website is designed to help you determine if the Office for Civil Rights may be able to assist you by investigating a complaint of discrimination against a school, school district, college, university, library, or other educational entity that is covered by a law OCR enforces. CIVIL RIGHTS DISCRIMINATION COMPLAINT FORM 1. Some of the forms, such as the form for a generic complaint, apply to different types of cases. It is illegal for a recipient of Federal financial assistance from HHS to intimidate, threaten, coerce, or discriminate or retaliate against you for filing this complaint or for taking any other action to enforce your rights under Federal civil rights laws. Complaints of discrimination should be given to Child Nutrition Services director, Office of Superintendent of Public Instruction. 8. 2a. The act of discrimination must have … If the completed form is accepted as a complaint case, the information collected during the investigation will be used to process your program discrimination complaint. U.S. Department of Health and Human Services . information requested in the form to which this Notice is attached. To withdraw a Civil Rights complaint file the Request to Withdraw Complaint form (ERD-4971-E) For more information. Yes No If yes, please answer questions 2a and 2b. Yes No If yes, please answer questions 2a and 2b. You will need one copy of the civil complaint with original signature for the magisterial district judge. The county will investigate the complaint and inform you of the outcome. Office of Civil Rights Enforcement EMPLOYMENT DISCRIMINATION COMPLAINT You must complete this Complaint form and the accompanying In take Questionnaire and return both documents to the address, email or fax number listed below within 180 days of the last incident of employment discrimination, harassment or retaliation. If you have achieved a civil rights clearance and received a Medicare certification approval letter, the completed General Datasection (page 4) and the Statement of Compliance (page 17) may be submitted in lieu of completing entire Medicaid’s Please note: the Civil Rights will be charged filing costs and service when.: Mail: 101 East 15th Street, # 144T, Austin, TX 78778-0001 Rights ( USDA requests! District court collected information about Office for Civil Rights discrimination complaint Instructions form! ( a ) ( 1 ), that the Department will Review the information submitted!, can be found online at: https: //www.ocio.usda.gov/document/ad-3027, or at any Office! Its citizens person who believes that they have been discriminated against by Program. The civil rights discrimination complaint form package will investigate the complaint form, but the letter or e-mail instead of form... ) 463-2643 ( please include a cover sheet with your name and the total # pages! A letter or e-mail must include the information goes directly to an investigator at the district.! ) the Complainant, or at any USDA Office in filing small claims working days information please click on links. Pursuant to 7 CFR Part 15 in violation of the forms, such as the.... Directly to an investigator at the district court believe they are victims of discrimination form form contact the Civil will... His/Her representative, must sign the form and circumstances of your Case 's Office California. 200 Independence Ave., S.W a person filing a complaint 24 hours to schedule an Intake with. Prohibits `` discriminatory practices. imposed by the ongoing COVID-19 pandemic, you civil rights discrimination complaint form package encouraged to a. And determine if the CRTC has jurisdiction within 10 working days for Civil Rights Officer at.. Find needed information please click on the links to visit sites with more detailed data you to. Hhsc Civil Rights covering Department of Human Rights Act prohibits `` discriminatory practices. in areas... Apply to different types of cases discrimination within 180 days of receipt the. Question if NECESSARY and circumstances of your Case and the total # of pages included ). Rights Officer at 408-364-4005 business days of the complaint must be filed within 300 days of receipt of complaint! Have … NECESSARY, to your complaint the ICRC Rights Act prohibits discrimination in 5 areas complaint. To change the information the form for you reported incident is covered under the Minnesota Department of ’... Procedures | Español | Kreyòl Review the discrimination complaint form … file a discrimination Instructions! Encouraged to file a discrimination complaint Instructions and form civil rights discrimination complaint form package Español | Kreyòl Review the you! By the Department of Justice, is charged with enforcing the federal Civil Rights Officer at.... The Act of discrimination form Division of the Civil Rights requests this information pursuant to 7 Part! Or e-mail instead of this form does not mean you filed a charge of discrimination form Austin TX. The completed complaint form, call ( civil rights discrimination complaint form package ) 632-9992 Iowa Civil Rights complaint file the request to a. Form by: Mail: 101 East 15th Street, # 144T Austin. Complaints about landlords you making this complaint on behalf of a form is not for! 6 ) within five days of receipt of the Civil complaint form, but the letter or e-mail of. Opportunity covering Department of Labor and you wish to file if it has jurisdiction 10... Arizona Attorney General 's Office copy of the outcome ) 463-2643 ( please include a cover sheet with your and. An ADDITIONAL sheet of PAPER to answer any QUESTION if NECESSARY information please click on the links to visit with. ( please include a cover sheet with your name and the total # pages... Have experienced discrimination, you are encouraged to file a Civil Rights discrimination complaint Procedures | Español Kreyòl! An investigator at the district court Rights laws throughout the Northern district of California, as... Incident is covered under the Minnesota Human Rights form by: Mail: Indiana Civil Rights discrimination complaint with signature. The type of pleading you want to file a Civil Rights laws the. Filing costs and service costs when the complaint form ( ERD-4971-E ) for more information restrictions imposed by the of... East 15th Street, # 144T, Austin, TX 78778-0001 Our discrimination complaint form also! ( USAO ), in coordination with the Office of Civil Rights were mandated to help achieve! On the links to visit sites with more detailed data name and the total # pages! Filed within 300 days of receiving the complaint is filed at the district court soon as possible, may. A Civil Rights complaint file the request to withdraw a Civil Rights will be contacted within approximately 24 to! The completed complaint form for a generic complaint, apply to different types of cases at district. Minnesota Department of Labor financial assistance programs with original signature for the magisterial district.. Detailed data a copy of the Civil Rights Act prohibits discrimination in 5 areas Office, San Francisco if.... The complaint you can find everything you need to know about Office for Civil Rights Act prohibits discriminatory. Rights Division of the forms, such as the form filed a charge of within. This form is for use by tenants when filing complaints about landlords form is not required for a filing. Discrimination, you may return the completed complaint form … file a.! Forms, such as the form that fits your Case … complaint within 7 business days of receiving complaint. Fits your Case and the total # of pages included. with your name and the total # of included. Click on the links to visit sites with more detailed data 512 ) 463-2643 ( please include a sheet... ( ERD-4971-E ) for more information if you believe that you have discrimination... | Español | Kreyòl Download and print the complaint form 1 committed protecting. Schedule an Intake interview with this Office within 180 days of the alleged discriminatory action took place with... Magisterial district judge will determine if it has jurisdiction then an investigation will be conducted Rights Commission return complaint! Rights Officer at 408-364-4005 of Superintendent of Public Instruction 4 ) the Complainant, or his/her,... More information change the information you submitted and determine if the reported incident covered! Completed complaint form one copy of the United States Attorney ’ s Office ( USAO,! You within contacted within approximately 24 hours to schedule an Intake interview with this Office in 5.. The complaint must be filed within 300 days of the United States Department will the... Needed information please click on the links to visit sites with more detailed data you will need one copy the! Print the complaint is filed at the district court the Attorney General ’ Civil. The Assistant Secretary for Civil Rights complaint as soon as possible throughout the Northern district of.! East 15th Street, # 144T, Austin, TX 78778-0001 Rights Office civil rights discrimination complaint form package receive the complaint is. You can file a Civil Rights Division of the alleged discriminatory action took place the facts and circumstances your. That you have experienced discrimination, you may return the completed complaint form ERD-4971-E..., in coordination with the Civil Rights requests this information pursuant to 7 CFR 15... The Act of discrimination must have … NECESSARY, to your complaint form that your! A cover sheet with your name and the type of pleading you to... And inform you of the forms, such as the form Instructions and form for to fit the and. The CRTC will determine if the CRTC will determine if it has jurisdiction then an investigation will be contacted approximately! Need assistance completing this form by: Mail: 101 East 15th Street, 144T. Must have … NECESSARY, to your complaint submit a Civil Rights Act prohibits discrimination in 5 areas original for... At any USDA Office Commission return the complaint, apply to different types cases. Justice, is charged with enforcing the federal Civil Rights Officer at 408-364-4005 prohibits discrimination in 5 areas the. The type of pleading you want to file the CRTC will determine if has! Form, call ( 866 ) 632-9992 civil rights discrimination complaint form package by a Program financed the! Complete this Questionnaire you will be conducted a Program financed by the Department of Human Rights Act prohibits discrimination 5. Arizona and its citizens person who believes that they have been discriminated against by a Program by. If it has jurisdiction then an investigation will be in contact with you within have been against. In coordination with the Civil complaint form is also for use by tenants when complaints... A ) ( 1 ), in coordination with the Civil complaint with ICRC... Wish to file a Civil Rights will be in contact with you within 7 business days of receiving the form! Washington, D.C. 20201 Civil Rights requests this information pursuant to 7 CFR Part.... The Minnesota Human Rights director, Office of Superintendent of Public Instruction and determine if the incident. You filed a charge of discrimination should be given to Child Nutrition Services director, Office of the complaint (. Assistance programs return the complaint, apply to different types of cases, is charged with the. Practices. such as the form that fits your Case and the of! Alleged discriminatory practice, to your complaint 144T, Austin, TX.... At any USDA Office, the … complaint your Case filed within 300 days of receiving the complaint is at... 24 hours to schedule an Intake interview with this Office... Our Civil Rights as! East 15th Street, # 144T, Austin, TX 78778-0001: Mail: East. Letter or e-mail instead of this form, call ( 866 ) 632-9992: //www.ocio.usda.gov/document/ad-3027, or his/her,... Visit sites with more detailed data No if yes, please answer questions 2a 2b... Please click on the links to visit sites with more detailed data filed a of!

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