Laserfiche WebLink
CITY OF SANTA ANA <br />TITLE VI COMPLAINT FORM <br />SECTION V <br />What remedy are you seeking for the alleged discrimination? <br />How did you learn that you could file this complaint? <br />SECTION VI <br />You may attach any written materials or other information that you think is relevant to your <br />complaint. <br />YOUR SIGNATURE AND TODAY'S DATE ARE REQUIRED BELOW: <br />Signature <br />Date <br />Please submit this completed form in person, or mail the form to: Anita Queen, Title VI - <br />Equal Opportunity Officer, City of Santa Ana, 20 Civic Plaza, M-24, 5th floor, Santa Ana, CA <br />92701. <br />Please make a copy for your records. <br />JULY 2012 <br />6 <br />25B-46