File an ADA Complaint

Paperwork Reduction Act Statement

This request is in accordance with the Paperwork Reduction Act of 1995, 44 U.S.C. § 3507.  This information collection is for the purpose of allowing the MHMR Emergency Management (EMD) to engage in authorized civil rights compliance and enforcement activities. Providing the information is voluntary, except that failure to provide such information may result in EMD being unable to process your complaint. The estimated average burden associated with this collection is 45 minutes per response, depending on individual circumstances. Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden may be sent by email at: Emergency.Management@mhmrtc.org.  An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.

Privacy Act Statement

The Americans with Disabilities Act of 1990, 42 U.S.C. §§ 12131-12134, and Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794, authorize the solicitation of the information for this form.  Providing the information is voluntary, except that failure to provide such information may result in the MHMR Emergency Management (EMD) being unable to process your complaint. The principal purpose of collecting information from you is for EMD’s authorized civil rights compliance and enforcement activities. EMD will not disclose your name or other identifying information about you unless it is necessary for enforcement activities against an entity alleged to have violated federal law, required to be disclosed under the Freedom of Information Act, 5 U.S.C. § 552, disclosure is permitted pursuant to the Privacy Act, or is otherwise required by law.