Civil Rights Complaint/Grievance Form

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View the Adams County Civil Rights Plan

Person filing complaint:

Person you are filing complaint about:

Nature of the civil rights complaint/grievance:

Check area that applies:

Please describe briefly what happened, how and why do you believe you have been discriminated against, and when this occurred:

One file only.
100 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip, csv.