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Office for Civil Rights Discrimination Complaint Form

Before completing this form, please read the information describing its use:
http://www.ed.gov/about/offices/list/ocr/complaintintro.html
required fields

1. Enter information about yourself

2. Who else can we call if we cannot reach you?

3. Who was discriminated against?

4. What institution discriminated?

OCR's laws cover educational institutions such as school districts, colleges and universities, public libraries and state vocational rehabilitation agencies.

5. Have you tried to resolve the complaint through the institution's grievance process, due process hearing, or with another agency?

6. Describe the discrimination

OCR enforces regulations that prohibit discrimination on the basis of race, color, national origin; sex; disability; and/or age.
On what basis were you discriminated against?
(You may select more than one.)

• date(s) the discriminatory action occurred;
• name(s) of individual(s) who discriminated;
• what happened;
• witnesses, (if any);
• why you believe the discrimination was because of
race, sex, disability, age, or whatever basis you indicated above or
why you believe the action was retaliatory.

Do you have written information that you think will help us understand your complaint?
You will be contacted with instructions for submitting this information (please do not send original documents).

7. Your complaint must be filed within 180 days of the discriminatory action

The laws that we enforce require that complaints be filed with our office within 180 days of the alleged discriminatory event. If any of the alleged discriminatory actions took place more than 180 days before the postmark or receipt date of this complaint, you may request a waiver of the 180-day limit.
The laws that we enforce require that complaints be filed with our office within 180 days of the alleged discriminatory event. If any of the alleged discriminatory actions took place more than 180 days before the postmark or receipt date of this complaint, you may request a waiver of the 180-day limit.
When did the last act of discrimination occur?
Are you requesting a waiver of the 180-day filing time limit for discrimination that occurred more than 180 days before the filing of this complaint?

8. What would you like the institution to do as a result of your complaint?

9. Please read!

Please read the Information About OCR's Complaint Processing Procedures, Office for Civil Rights Notice About Investigatory Uses of Personal Information, and OCR Complaint Consent Form. All these documents are downloadable. Before we can complete initial processing of your complaint, we will need your signed consent authorizing us to proceed. Please sign and date A or B on the consent form and mail it to the OCR Enforcement Office responsible for your complaint.
Click 'submit' to send your complaint to OCR. Your complaint will be routed to the OCR office with authority to handle complaints in the state where the institution or entity you are complaining about is located. A staff person will contact you once we receive your electronic complaint form.

Please click 'Submit' only once and do not refresh the page after your submission.