Do I need a notary for the ADA grievance form?

No. The grievance form asks for the complainant’s signature but does not require notarization or mention a notarized or sworn attachment.

What information does the ADA grievance form ask for?

It asks for contact information, details about the person affected, the alleged violation and its date, the requested action, and whether a complaint was filed with an agency.

Can I file an ADA grievance orally?

Yes. The procedure says you can contact the ADA Coordinator to file orally. The coordinator will put the grievance in writing on the form, which the grievant signs.

La Puente, CA · Los Angeles County

No notary required

ADA Notice and Grievance Procedure

This form lets people file a complaint about access to City of La Puente programs, services, or facilities under the city’s ADA grievance procedure.

What this form is

The document explains the City of La Puente’s accessibility commitments and grievance procedure, and includes a form for reporting an alleged ADA violation. Use the form when a request for access to city programs, services, or facilities cannot be resolved and you want to file a written grievance. It asks for contact details, information about the person affected, the alleged violation, requested action, and any related agency complaint.

Who needs it

People who want to submit a written grievance about an alleged accessibility violation involving a City of La Puente program, service, or facility can use this form.

How to submit it

File the written grievance with the ADA Coordinator, City of La Puente, Risk Manager, 15900 E. Main Street, La Puente, CA 91744. The document also says a grievance may be filed orally by contacting the coordinator at (626) 855-1515.

About notarization

This document is signed without a notary; the grievance form asks the complainant to sign and does not mention any notarized or sworn attachment.

How to submit this form

1
Download The Form
Download the ADA Notice and Grievance Procedure, which includes the ADA Grievance Form.
2
Complete The Grievance Form
Provide the requested contact details, violation information, requested action, and related complaint information, then sign the form.
3
Gather Related Information
Include information about any complaint filed with an agency or court, if applicable.
4
Submit To The City
Send the written grievance to the ADA Coordinator at the Risk Manager address listed in the procedure, or contact the coordinator to file orally.

Frequently asked questions

Do I need a notary for the ADA grievance form?: No. The grievance form asks for the complainant’s signature but does not require notarization or mention a notarized or sworn attachment.
How do I submit an ADA grievance in La Puente?: Send a written grievance to the ADA Coordinator, City of La Puente, Risk Manager, 15900 E. Main Street, La Puente, CA 91744. You may also file orally by contacting the coordinator.
What information does the ADA grievance form ask for?: It asks for contact information, details about the person affected, the alleged violation and its date, the requested action, and whether a complaint was filed with an agency.
Can I file an ADA grievance orally?: Yes. The procedure says you can contact the ADA Coordinator to file orally. The coordinator will put the grievance in writing on the form, which the grievant signs.

Need something notarized?

This ADA Notice and Grievance Procedure doesn’t need a notary — but if you have another La Puente form that does, a commissioned online notary can help.