Civil Rights Complaint Form - ode state or us 2025

1. Click ‘Get Form’ to open the Civil Rights Complaint Form in the editor.
2. Begin by filling out your contact information. Enter your name, street address, city, state, and ZIP code in the designated fields.
3. Provide your area code and phone number, followed by your email address to ensure you can be contacted regarding your complaint.
4. In the complaint information section, specify the name and location of the entity delivering the service or benefit that you are complaining about.
5. Describe the incident or action that you believe constitutes discrimination. Be as detailed as possible to provide context.
6. Indicate on what basis you feel discrimination exists (e.g., race, color, national origin).
7. List any individuals who may have knowledge of the alleged discriminatory actions along with their titles and business addresses.
8. Document the date(s) when these actions occurred or indicate if they are ongoing.
9. Finally, review all entries for accuracy before submitting your completed form through our platform.

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