No description provided for imageAccessibility Complaints American with Disabilities Act (ADA) Complaint Form Name* First Last Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Phone*Email* What issues are associated with your complaint?* Employment Public Access Other When did the alleged discrimination occur?* MM slash DD slash YYYY Where did the alleged discrimination occur?* Describe what happened:*Were there any witnesses to the alleged discrimination?* Yes No If yes, Please provide witnesses names and contact number:Have efforts been made to resolve this complaint?* Yes No If yes, what is the status?What corrective action do you believe would address your complaint?*Have you filed a previous complaint of alleged discrimination?* Yes No If yes, please describe the incident and when it occurred:Who did you file this complaint with?*Please notify the Airport ADA Compliance Coordinator of any changes of address and telephone number during the period of the investigation.Affirmation* I affirm that the above complaint is true and accurate to the best of my knowledge, information and belief.Name First Last Date MM slash DD slash YYYY EmailThis field is for validation purposes and should be left unchanged.