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Discrimination Complaint - Publication Accommodation or Amusement

Document Number:  ERD-10241-E

Description:  This form should be used to file a Public Accommodation or Amusement Complaint.

Comments:  This form must be notarized.

Content Contact:  Equal Rights Information

Document Attachments:

ERD-10241-E (Electronic Version - Word/136 KB)  Fill in online, print and save. You must have MS Word to save the completed form.

ERD-10241 (Print Version - PDF/111 KB)  Print and fill in by hand. This version can not be completed online but can be printed and filled in by hand. This format will work with all computer operating systems. This requires the free Adobe Acrobat Reader to view and print the blank form.

 

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