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USDA Program Discrimination Complaint Form

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File a Program Discrimination Complaint Online

If you believe you experienced discrimination while applying for or participating in a USDA program or activity, you may use the online Program Discrimination Complaint Intake Form below to submit your complaint to the U.S. Department of Agriculture’s Office of the Assistant Secretary for Civil Rights. Complete the form below to begin the complaint intake process.

Complainant Information

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Language and Accessibility Assistance Notice

If you have difficulty understanding the English language, you may request language assistance services by calling 866-632-9992. Assistance is available for individuals who are not proficient in English. Persons with disabilities who require alternative means of communication, such as Braille, large print, or American Sign Language, should contact the responsible State or local agency that administers the program or contact USDA through the Federal Telecommunications Relay Service at 711.

Representative Information

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Complaint Information

Select the USDA agency that conducts the program or provides Federal financial assistance for the program.
Unlimited number of files can be uploaded to this field. 5 MB limit. Allowed types: pdf.

Basis of Discrimination

It is a violation of the law to discriminate against you based on race, color, national origin, religion, sex, disability, age, marital status, family/parental status, income derived from a public assistance program, and political beliefs. Not all bases apply to all programs. Reprisal is prohibited based on prior civil rights activity.

I believe I was discriminated against based on:

Remedies

Prior Complaint Filing

Signature and Certification

We must have a signed copy of your complaint. An incomplete or unsigned form or letter may delay processing of your complaint.

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Filing Deadline Notice

A program discrimination complaint must be filed within 180 days from the date you knew or should have known of the alleged discrimination unless the time for filing is extended by USDA. Complaints filed after the 180-day deadline must include a good cause explanation for the delay.

Submission Options Notice

You may submit your completed complaint form or letter to USDA by mail or email.

Mail:
U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Mail Stop 9410
Washington, DC 20250-9410

Email: program.intake@usda.gov

By Form: Complete the USDA Program Discrimination Complaint Form (English) or USDA Program Discrimination Complaint Form (Spanish)

Acknowledgements
CONSENT: This USDA Program Discrimination Complaint Form is provided in accordance with the Privacy Act of 1974 (5 U.S.C. §552a) and is used to solicit information for processing complaints of discrimination. USDA requests this information pursuant to 7 CFR Part 15. If the completed form is accepted as a complaint, the information collected during the investigation will be used to process your program discrimination complaint.
AUTHORITIES: Collection of this information is authorized by Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d); and Sections 504 and 508 of the Rehabilitation Act of 1973 (29 U.S.C. §§ 794; 794d) and any other anti- discrimination statutes, rules and regulations. PURPOSE: The information solicited on this form is used for processing complaints of discrimination under the statutes listed in the "Authorities" section of this notice. Any information obtained from this form will be maintained in our system of record. ROUTINE USES: More information on the routine uses for the system can be found in the System of Records Notice USDA-2021-0007 records maintained by OASCR can be seen via the internet at www.usda.gov/privacy-policy/system-records-notices. DISCLOSURE: Providing this information is voluntary. Failure to complete this form may lead to a delay in processing of the complaint or rejection of the complaint due to an inadequate information to continue processing.
The Paperwork Reduction Act of 1995 (44 U.S.C. 3501 et seq.) requires us to inform you that this information is being collected to ensure that your complaint contains all the information required to process it fully. OASCR will use the information to process your discrimination complaint. Response to this request is voluntary. The information you provide on this form will only be shared with persons who have an official need to know and will be protected from public disclosure pursuant to the provisions of the Privacy Act, (5 U.S.C. § 552a(b)). The estimated time required to complete this form is 60 minutes. You may send comments regarding the accuracy of this estimate and any suggestions for reducing the time for completion of the form to the U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Mail Stop 9410, DC 20250-9410. An agency may not conduct or sponsor, nor is a person required to respond to, a collection of information unless it displays a currently valid OMB Control Number. The OMB Control Number for this form is 0508-0002.
RETALIATION PROHIBITED: No Agency, officer, employee, or agent of the USDA, including persons representing the USDA and its programs, shall intimidate, threaten, harass, coerce, discriminate against, or otherwise retaliate against anyone who has filed a complaint of alleged discrimination or who participates in any manner in an investigation or other proceeding raising claims of discrimination.
Section 508 of the Rehabilitation Act of 1973, as amended (29 U.S.C. 794d) authorizes individuals to file administrative complaints and civil actions against the Department, limited to the Department’s alleged failure to procure accessible technology. The statute requires federal agencies to process Section 508 complaints according to the same complaint procedures used to process Section 504 complaints. USDA is committed to making its digital content accessible. USDA customers, employees, job applicants, and members of the public with disabilities must have access to information and communication technology (ICT) comparable to the access available to those without disabilities.
Title VI of the Civil Rights Act of 1964 requires federal agencies to ensure that programs or activities receiving federal funding, including those that affect human health, do not use discriminatory criteria, methods, or practices that adversely impact protected groups. USDA is advancing justice by carrying out its responsibilities under the law to identify and address disproportionate and adverse public and cumulative impacts on communities with concerns. USDA invites the public to bring to its attention possible violations of our nation's laws. Please understand that submitting this complaint form has no effect on any statute of limitations or other filing requirements that might apply to any complaint you may have. Further, by submitting this complaint you have not commenced a lawsuit or other legal proceeding, and this office has not initiated a lawsuit or proceeding on your behalf.
Discrimination based on national origin includes discrimination based on the country, world region, or place where a person or their ancestors come from; a person's limited English proficiency or English learner status; and a person's actual or perceived shared ancestry or ethnic characteristics, including membership in a religion that may be perceived to exhibit such characteristics (e.g., Hindu, Jewish, Muslim, and Sikh students).

Acknowledgement

I acknowledge that I have reviewed the filing instructions, Privacy Act Statement, Paperwork Reduction Act Statement, and related legal notices before submitting this complaint.
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