Fair Housing Complaint Form

Please fill out the following form. Be sure to include as many details as possible regarding your complaint.

First Name
Last Name
Email Address
Phone Number
Address
City
State
ZIP
Secondary Contact's First Name
Secondary Contact's Last Name
Secondary Contact's Organization
Secondary Contact's Phone Number
What happened to you? How were you discriminated against? For example: were you refused an opportunity to rent or buy housing? Denied a loan? Told that housing was not available when in fact it was? Treated differently from others seeking housing?
Why do you believe that you are being discrimated against? It is a violation of the law to deny you your housing rights for any of the following factors: race, color, religion, sex, national origin, familial status (children under 18), disability
Who was the person you believe discriminated you? Provide name, address, whether they were a landloard, real estate agent, an organization, other?
Where did the alleged act of discrimination occur? Provide the address.
When did the last date of discrimination occur?
Security Code
Security Code