Fulton County, IL · Fulton County
ADA / Title VI Complaint Form
Fulton County residents may use this form to report alleged discrimination involving the Americans with Disabilities Act or Title VI.
At a glance
- Issued by
- City of Fulton County · Fulton County, Fulton County, Illinois
- Notarization
- Not required: file this form without a notary.
- Official source
- fultoncountyil.gov
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
What this form is
Use this form to file an ADA or Title VI complaint with Fulton County. It asks for your contact information, the basis and date of the alleged discrimination, and details about what happened. It also asks whether you have filed related complaints elsewhere and provides space for a signature and date. The form states that complaints must be filed within 180 days of the alleged discrimination.
Who needs it
Anyone filing an ADA or Title VI discrimination complaint with Fulton County can use this form to provide details about the allegation.
How to submit it
Submit the form in person or by mail to the ADA / Title VI Coordinator, Fulton County, 100 N. Main Street, Lewistown, IL 61542.
About notarization
This document is signed without a notary; the form asks the complainant to sign and date it.
How to submit this form
- 1
Download the Form
Download the Fulton County ADA / Title VI Complaint Form PDF.
- 2
Complete the Form
Select ADA or Title VI, provide your contact information, and describe the alleged discrimination and people involved.
- 3
Gather Supporting Information
You may use the back for additional comments or attach written materials or other information relevant to your complaint.
- 4
Sign and Submit
Sign and date the form, then submit it in person or by mail to the coordinator at the address listed on the form.
Frequently asked questions
- What is the Fulton County ADA / Title VI Complaint Form for?
- It is used to file an ADA or Title VI complaint with Fulton County. The form collects details about the alleged discrimination, including its date, basis, and people involved.
- Do I need a notary for the ADA / Title VI Complaint Form?
- No. This document is signed without a notary; the form asks the complainant to sign and date it.
- How do I submit the ADA / Title VI Complaint Form?
- Submit it in person or by mail to the ADA / Title VI Coordinator, Fulton County, 100 N. Main Street, Lewistown, IL 61542. The form states that complaints must be filed within 180 days following the alleged discrimination.