Please complete this form if you wish to file a complaint. Fields marked with an asterisk (*) are required. You must click the Submit Form button at the bottom to finish.
(Government, organization, institution or business which you believe has discriminated.)
*Has the complaint been filed with any other Federal, State,
or local civil rights agency or courts?
This form data will not be retained by the website, only forwarded to the appropriate staff. If desired, print a copy for your own records before submitting.