Housing Discrimination Information Form (Short) printable pdf download

MAIL

WHERE TO

YOUR FORM OR

YOUR CLAIM

INQUIRE ABOUT

For Connecticut, Maine, Massachusetts, New

For arkansas, louisiana, New Mexico, oklahoma, &

Hampshire, Rhode Island, and Vermont:

texas:

BostoN RegIoNal oFFICe

FoRt woRtH RegIoNal oFFICe

Fair Housing Office

Fair Housing office

U.S. Department of Housing and Urban Development

U.s. Dept. of Housing and Urban Development

Thomas P. O’Neill Jr. Federal Building

801 Cherry Street

10 Causeway Street, Room 321

Suite 2500, Unit #45

Boston, MA 02222-1092

Fort Worth, TX 76102-6803

Telephone (617) 994-8300 or 1-800-827-5005

Telephone (817) 978-5900 or 1-888-560-8913

Fax (617) 565-7313 • TTY (617) 565-5453

Fax (817) 978-5876/5851 • TTY (817) 978-5595

E-mail: Complaints_office_01@hud.gov

E-mail: Complaints_office_06@hud.gov

For New Jersey, New York, and the Caribbean:

For Iowa, kansas, Missouri and Nebraska:

New YoRk RegIoNal oFFICe

kaNsas CItY RegIoNal oFFICe

Fair Housing Office

U.S. Department of Housing and Urban Development

26 Federal Plaza, Room 3532

Gateway Tower II

New York, NY 10278-0068

400 State Avenue, Room 200, 4th Floor

Telephone (212) 542-7519 or 1-800-496-4294

Kansas City, KS 66101-2406

Fax (212) 264-9829 • TTY (212) 264-0927

Telephone (913) 551-6958 or 1-800-743-5323

E-mail: Complaints_office_02@hud.gov

Fax (913) 551-6856 • TTY (913) 551-6972

Victim

Are You a

E-mail: Complaints_office_07@hud.gov

For Delaware, District of Columbia, Maryland,

Pennsylvania, Virginia, and west Virginia:

For Colorado, Montana, North Dakota, south Dakota,

HOUSING

PHIlaDelPHIa RegIoNal oFFICe

Utah, and wyoming:

Fair Housing Office

DeNVeR RegIoNal oFFICe

U.S. Department of Housing and Urban Development

Fair Housing Office

The Wanamaker Building

U.S. Department of Housing and Urban Development

100 Penn Square East

1670 Broadway

Philadelphia, PA 19107-9344

Denver, CO 80202-4801

Telephone (215) 861-7646 or 1-888-799-2085

Telephone (303) 672-5437 or 1-800-877-7353

DISCRIMINATION?

Fax (215) 656-3449 • TTY (215) 656-3450

Fax (303) 672-5026 • TTY (303) 672-5248

E-mail: Complaints_office_03@hud.gov

E-mail: Complaints_office_08@hud.gov

FAIR HOUSING

For alabama, Florida, georgia, kentucky, Mississippi,

For arizona, California, Hawaii, and Nevada:

If you have been denied

North Carolina, south Carolina, and tennessee:

saN FRaNCIsCo RegIoNal oFFICe

atlaNta RegIoNal oFFICe

your housing rights...you

Fair Housing Office

U.S. Department of Housing and Urban Development

Your Right!

may have experienced

U.S. Department of Housing and Urban Development

600 Harrison Street, Third Floor

Five Points Plaza

San Francisco, CA 94107-1387

unlawful discrimination.

40 Marietta Street, 16th Floor

Telephone 1-800-347-3739

Atlanta, GA 30303-2808

Fax (415) 489-6558 • TTY (415) 489-6564

Telephone (404) 331-5140 or 1-800-440-8091 x2493

E-mail: Complaints_office_09@hud.gov

Public Reporting Burden for this collection of information is estimated to average 20 minutes per response, including the

Fax (404) 331-1021 • TTY (404) 730-2654

For alaska, Idaho, oregon, and washington:

time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing

E-mail: Complaints_office_04@hud.gov

seattle RegIoNal oFFICe

and reviewing the collection of information.

For Illinois, Indiana, Michigan, Minnesota, ohio, and

Fair Housing Office

The Department of Housing and Urban Development is authorized to collect this information by Title VIII of the Civil Rights

wisconsin:

U.S. Department of Housing and Urban Development

Act of 1968, as amended by the Fair Housing Amendments Act of 1988, (P.L. 100-430); Title VI of the Civil Rights Act of 1964,

CHICago RegIoNal oFFICe

Seattle Federal Office Building

(P.L. 88-352); Section 504 of the Rehabilitation Act of 1973, as amended, (P.L. 93-112); Section 109 of Title I- Housing and

Fair Housing Office

909 First Avenue, Room 205

Community Development Act of 1974, as amended, (P.L. 97-35); Americans with Disabilities Act of 1990, (P.L. 101-336); and

U.S. Department of Housing and Urban Development

Seattle, WA 98104-1000

by the Age Discrimination Act of 1975, as amended, (42 U.S.C. 6103).

Ralph H. Metcalfe Federal Building

Telephone (206) 220-5170 or 1-800-877-0246

The information will be used to investigate and to process housing discrimination complaints. The information may be

77 West Jackson Boulevard, Room 2101

Fax (206) 220-5447 • TTY (206) 220-5185

disclosed to the United States Department of Justice for its use in the filing of pattern and practice suits of housing discrimination

Chicago, IL 60604-3507

or the prosecution of the person(s) who committed that discrimination where violence is involved; and to State or local fair

E-mail: Complaints_office_10@hud.gov

Telephone 1-800-765-9372

housing agencies that administer substantially equivalent fair housing laws for complaint processing. Failure to provide some

If after contacting the local office nearest you, you still

Fax (312) 886-2837 • TTY (312) 353-7143

or all of the requested information will result in delay or denial of HUD assistance.

have questions – you may contact HUD further at:

Disclosure of this information is voluntary.

E-mail: Complaints_office_05@hud.gov

U.S. Dept. of Housing and Urban Development

Office of Fair Housing and Equal Opportunity

451 7th Street, S.W., Room 5204

Washington, DC 20410-2000

1540

Telephone 1-800-669-9777

Fax (202) 708-1425 • TTY 1-800-927-9275

U.S. Department of Housing and Urban Development

To file electronically, visit:

• Hotline:

1-800-669-9777

Housing Discrimination Information Form (Short)

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