Downey, CA · Los Angeles County
Title II ADA Reasonable Accommodation Form
This form lets a person with a disability request an accommodation for access to City of Downey facilities, services, activities, or programs.
What this form is
The City of Downey uses this form as an initial step in processing a request for a reasonable accommodation under Title II of the ADA. It asks for the requestor’s contact information and details about the activity or event, including its date and location, and the accommodation requested. For event requests, the form asks applicants to allow four business days for processing and possible arrangements.
Who needs it
A person with a disability requesting an accommodation for access to a City of Downey facility, service, activity, or program should complete this form.
How to submit it
Email the completed form to the ADA/Section 504 Coordinator at [email protected], or mail it to 11111 Brookshire Avenue, Downey, CA 90241. The form also lists a phone and fax number.
About notarization
This document is signed and dated without a notary; the signer just signs and dates the form, with no notarized or sworn attachment described.
How to submit this form
- 1
Download The Form
Download the City of Downey Title II ADA Reasonable Accommodation Form.
- 2
Complete The Form
Enter your contact information and details about the activity or event and the accommodation requested.
- 3
Add Any Extra Sheets
If you need more space, attach sheets and identify the paragraph or paragraphs you are answering.
- 4
Sign And Date
Sign and date the completed form.
- 5
Submit To The City
Email the form to [email protected] or mail it to the address listed on the form.
Frequently asked questions
- What is the Title II ADA Reasonable Accommodation Form for?
- The City of Downey uses this form as an initial step for a request to modify or adjust access to city facilities, services, activities, or programs.
- Who should complete this form?
- A person with a disability requesting an accommodation for a City of Downey facility, service, activity, or program can provide their contact information and request details on the form.
- How do I submit the ADA Reasonable Accommodation Form?
- Email the completed form to [email protected] or mail it to the ADA/Section 504 Coordinator at 11111 Brookshire Avenue, Downey, CA 90241.
- Do I need a notary for this form?
- No. This form is signed and dated without a notary, and it describes no notarized or sworn attachment.