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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
ERD-10241-E (Electronic Version - Word/133 KB)
ERD-10241 (Print Version - pdf/158 KB)
Note: If you need this form in an alternate format, please send a message to the Content Contact listed above.