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COMPLAINT UNDER AMERICANS WITH DISABILITIES ACT (Title II) and Section 504 Michigan Department of Human Services Instructions: Please fill out this form completely, in black ink or type. Sign and return to the address on page 2. Complainant Name: Address: City Telephone: Home: Business: ( ( ) ) State Zip Code Person Completing This Form: (if other than the complainant) Address: City Telephone: Home: Business: ( (...
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