Washington County, GA · Washington County
ADA Citizens Grievance Form
Washington County citizens use this form to submit a written grievance alleging the County breached or misapplied Americans with Disabilities Act provisions.
At a glance
- Issued by
- City of Washington County · Washington County, Washington County, Georgia
- Notarization
- Not required: file this form without a notary.
- Official source
- washingtoncountyga.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
This form lets a Washington County citizen document an alleged breach, misinterpretation, improper application, or non-compliance with Americans with Disabilities Act provisions. The grievance must be identified in writing to the County Administrator within seven working days of the incident. It asks for the grievant’s contact details and signature, incident date and time, location, relevant ADA provisions, and a description of the problem.
Who needs it
A Washington County citizen alleging an ADA-related grievance against the County may use this form, or a legal representative may file if the citizen cannot.
How to submit it
Submit the written grievance to the County Administrator within seven working days of the incident. Later steps direct unresolved grievances to the County Attorney, Board of County Commissioners, and, if still unsettled, the U.S. Department of Justice.
About notarization
This document is signed without a notary; the grievant or authorized legal representative signs and dates the written grievance.
How to submit this form
- 1
Download the Form
Download the Washington County ADA Citizens Grievance Form PDF.
- 2
Complete the Written Grievance
Provide the requested contact details, incident information, relevant ADA provisions, and problem description; sign and date the grievance.
- 3
Gather Any Additional Pages
Attach an additional page if needed to describe the incident or problem.
- 4
Submit to the County Administrator
Submit the written grievance to the County Administrator within seven working days of the incident.
Frequently asked questions
- What is the Washington County ADA Citizens Grievance Form for?
- It lets a citizen submit a written allegation that Washington County breached, misinterpreted, improperly applied, or failed to comply with Americans with Disabilities Act provisions.
- What information does the grievance form request?
- It requests the grievant’s name, address, phone number and signature, filing date, incident date and time, location, the specific ADA provisions involved, and a description of the problem.
- How do I submit a Washington County ADA grievance?
- Identify the alleged grievance in writing to the County Administrator within seven working days of the incident. If unresolved, the procedure describes later steps involving the County Attorney and Board of County Commissioners.
- Do I need a notary for the ADA Citizens Grievance Form?
- No. This document is signed without a notary; the grievant or authorized legal representative signs and dates the written grievance.