Rush Notary

Quincy, WA · Grant County

No notary required

ADA Reasonable Accommodations Request Form

This form lets people request an accommodation and identify the City of Quincy department responsible for the program, activity, or service.

What this form is

The form lets a requester describe an accommodation and identify the City of Quincy department responsible for the program, activity, or service. Use it to request an accommodation related to a city program, activity, or service. It asks what accommodation is requested and which department is responsible; the provided text does not list supporting documents or eligibility details.

Who needs it

A person requesting an accommodation for a City of Quincy program, activity, or service can use this form.

How to submit it

Mail the form to Stephanie Boorman, ADA Coordinator, PO Box 338, Quincy, WA 98848, or deliver it to Quincy City Hall, 104 B St SW, Quincy, WA 98848.

About notarization

This form is completed without a notary; it lists no notarized attachment or sworn step.

How to submit this form

  1. 1

    Download The Form

    Download the ADA Reasonable Accommodations Request Form.

  2. 2

    Describe The Request

    Describe the accommodation you are requesting.

  3. 3

    Name The City Department

    Identify the City of Quincy department responsible for the program, activity, or service.

  4. 4

    Submit The Form

    Mail it to the ADA Coordinator or deliver it to Quincy City Hall using the addresses shown on the form.

Frequently asked questions

What does the ADA Reasonable Accommodations Request Form ask for?
It asks you to describe the accommodation you are requesting and name the City of Quincy department responsible for the program, activity, or service.
Who can use this form?
A person requesting an accommodation related to a City of Quincy program, activity, or service can use the form to describe the request.
How do I submit the accommodation request form?
Mail it to Stephanie Boorman, ADA Coordinator, PO Box 338, Quincy, WA 98848, or deliver it to Quincy City Hall, 104 B St SW, Quincy, WA 98848.
Do I need a notary for this accommodation request?
No. This form is completed without a notary, and the document lists no notarized attachment or sworn step.

Need something notarized?

This ADA Reasonable Accommodations Request Form doesn’t need a notary — but if you have another Quincy form that does, a commissioned online notary can help.