If you believe you or someone else has experienced a civil rights violation, please tell us what happened.
You are continuing your complaint without providing email or phone information.
You do not have to provide contact information, however, we will not be able to contact you for any status updates or potential follow up. Would you like to add your contact information now? If you prefer not to, you will go to Step 2.
OMB #1190-0020
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number.
Public reporting burden for this collection of information is estimated to average 2 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
The personal description question is estimated to take 10 minutes for the response, time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. The obligation to respond to this collection is voluntary.
Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to:
U.S. Department of Justice
Civil Rights Division
950 Pennsylvania Avenue, NW
Washington, D.C. 20530-0001
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