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Get IA ICRC Complaint Form

St date that something discriminatory happened to you? ___________ What happened on that date? _____________________________________________ Please fill in the particulars of your complaint below. Be sure to state why you feel you were discriminated against. I certify under penalty of perjury and pursuant to the laws of the State of Iowa and the laws of the United States of America that the preceding charge is true and correct. X _____________________________________________ Date ______________.

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