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Online Discrimination Complaint Form

This form is only for submitting Civil Rights complaints of discrimination.

If you feel that you have been discriminated against, you may complete the PA 607, Complaint of Discriminatory Treatment form at any DPSS public facing office or you may submit your complaint directly to the Civil Rights Section by completing the form fields on this page.

NOTE: This form is intended for DPSS Customers or their Authorized Representatives only.

Claimant Position
I believe I was discriminated against because of my (check at least one box):
Consent