Nanticoke, PA · Luzerne County
Section 504 Grievance Form
The Section 504 Grievance Form lets people submit a complaint or request about discrimination, housing, or other listed issues to the City of Nanticoke.
What this form is
Use this form to describe a Section 504 grievance involving the City of Nanticoke. It asks for your contact information, incident date, request type, details about what happened, and City staff members contacted. The form includes spaces for your signature and date, and says to attach additional documentation if applicable.
Who needs it
A person wishing to report a grievance or request listed on the form to the City of Nanticoke should complete it.
How to submit it
Submit it to the city department named on the form; check the city website for current contact details.
About notarization
This form is signed and dated without a notary; attach additional documentation if applicable, but the form does not say attachments must be sworn.
How to submit this form
- 1
Download the Form
Download the City of Nanticoke Section 504 Grievance Form.
- 2
Complete the Form
Enter your contact information, incident date, request type, and a detailed description of what happened.
- 3
Gather Attachments
Attach additional documentation if applicable.
- 4
Submit to the City
Submit it to the city department named on the form; check the city website for current contact details.
Frequently asked questions
- What is the Section 504 Grievance Form for?
- It lets a person describe a grievance or request, including discrimination, housing-related issues, or a complaint, to the City of Nanticoke.
- Who should complete this form?
- A person wishing to report a grievance or request listed on the form to the City of Nanticoke can provide their contact details and describe what happened.
- Do I need a notary for the Section 504 Grievance Form?
- No. The form has a signature and date line but no notary block. It says to attach additional documentation if applicable, without saying attachments must be sworn.
- How do I submit the Section 504 Grievance Form?
- The form lists the City of Nanticoke address but does not give submission instructions. Submit it to the city department named on the form; check the city website for current contact details.