Request For State Complaint Investigation - Illinois State Board Of Education
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3ILLINOIS STATE BOARD OF EDUCATION
Special Education Services Division - Springfield
100 North First Street
Springfield, IL 62777-0001
217/782-5589; 217/782-0372 (fax)
REQUEST FOR STATE COMPLAINT INVESTIGATION
(This form is not the form to use to file for a due process hearing)
Per federal regulations at 34 CFR 300.509, this form has been developed to assist parents and other
parties in filing a State complaint. The use of this form is recommended, but not required. The completed
form should be sent to the address, listed below, at the Illinois State Board of Education (ISBE). A copy
of the form must also be forwarded to the child’s local school district or to the public agency that is
serving the child.
For more information about the complaint investigation process, or for assistance in completing this form,
please contact our agency at 217-782-5589, or use our agency’s toll-free number at 866-262-6663.
More
information
about
the
complaint
investigation
process
can
also
be
found
at
spec-ed/html/complaint_investigation.htm.
SECTION 1
To:
Complaint Coordinator
*You must also send a copy of this complaint
Special Education Services Division
to your local school district superintendent.
Illinois State Board of Education
100 N. First Street
To: _____________________________________
Springfield, IL 62777-0001
Name of School District
Date Sent: _______________________________
Date Sent: _______________________________
SECTION 2
COMPLAINANT INFORMATION (Please Print or Type)
Name:___________________________________ Phone Number:___________________________
Address:__________________________________________________________________________
Email Address (Optional):_________________________________________________________
Relationship to Student: ____Parent/Guardian ____Advocate ____Attorney ____Other (Explain)
Consent is Attached (see note below): ______Yes ______No
_______NA
Note: Complaints regarding a specific child lodged by an individual other than the parent/guardian must be
accompanied by a letter of consent from the parent/guardian in order for ISBE to share information with the
complainant regarding the results of the complaint investigation. Likewise, if an individual files a complaint on
behalf of a student who is eighteen (18) years of age or older, it must be accompanied by a letter of consent
from the student in order for ISBE to share information with the complainant regarding the results of the
complaint investigation.
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