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This document is a complaint form for individuals to report violations of the Americans with Disabilities Act (ADA) in the city of Somerville, Massachusetts. It collects information regarding the
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How to fill out Americans with Disabilities Act Complaint Form

01
Obtain the Americans with Disabilities Act Complaint Form from the ADA website or your local ADA office.
02
Read the instructions carefully before filling out the form.
03
Provide your personal information including your name, address, phone number, and email address.
04
Specify the name and address of the person or organization you are filing the complaint against.
05
Describe the nature of your complaint, including details of the alleged discrimination and any relevant dates.
06
Provide information about any efforts you have made to resolve the issue directly with the person or organization.
07
Sign and date the form to certify the information is true and accurate.
08
Submit the completed form to the appropriate ADA office either by mail, in person, or online if available.

Who needs Americans with Disabilities Act Complaint Form?

01
Individuals who believe they have been discriminated against because of a disability.
02
Organizations or advocates seeking to represent individuals facing disability discrimination.
03
Anyone seeking to report barriers to accessibility in public places.
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The Americans with Disabilities Act Complaint Form is a legal document that individuals can use to report alleged discrimination based on a disability under the Americans with Disabilities Act (ADA).
Any individual who believes they have been discriminated against based on their disability in programs, services, or activities covered by the ADA is encouraged to file a complaint using this form.
To fill out the form, one should provide personal information, details about the alleged discriminatory act, the parties involved, and any other relevant information such as dates and witnesses. It is important to ensure clarity and completeness when providing this information.
The purpose of the form is to document incidents of discrimination and initiate an investigation into the matter to ensure compliance with the ADA and protect the rights of individuals with disabilities.
The form must include the complainant's contact information, a description of the alleged discrimination, the location and date of the incident, the individuals or entities involved, and any other pertinent details that could assist in the investigation.
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