Get Available In Alternative Format Upon Request. - State Of Indiana

This guide provides clear instructions on how to accurately fill out the Available In Alternative Format Upon Request form of the State of Indiana. Our aim is to help you navigate the process seamlessly and ensure your request is processed effectively.

Follow the steps to successfully complete the form.

1. Click ‘Get Form’ button to obtain the form and open it in your preferred editor.
2. Begin by entering your personal information in the 'Complainant Information' section. This includes your full name, address, and contact numbers (home, work, and cellular). Make sure all information is accurate and complete.
3. Identify the person or agency you believe discriminated against you. Provide their name, title, and address, along with their contact numbers.
4. Specify the date of the last alleged discriminatory act. Remember, discrimination complaints must be filed within 180 days of the incident. If it’s been longer, please briefly explain your delay.
5. Select the basis of discrimination from the provided options, such as race, color, disability, etc. Provide concise information on the alleged discriminatory act. If necessary, use additional pages for detailed descriptions.
6. List any witnesses who can provide additional information regarding your complaint, including their names, titles, and contact details. Describe how each witness can support your case.
7. Indicate how you would like your complaint to be resolved. Provide any requests or specific outcomes you wish to see.
8. If you have filed similar complaints with other agencies, answer accordingly and provide the necessary details for each agency.
9. Remember to sign and date the form to validate your complaint. Without your signature, the complaint cannot be processed.
10. After completing the form, save any changes made. You can then download, print, or share the form as needed. Ensure that you keep a copy of your submission for your records.

Complete your request using the online form today for assistance in an alternative format.