OMB control number
Complaint of Discrimination Under Section 504, Section 508 or Title VI
OMB 1405-0220 · STATE/AFA.
OMB 1405-0220
The DS-4282 will be used to submit complaints of discrimination under Title VI of the Civil Rights Act of 1964; and Sections 504 and 508 of the Rehabilitation Act of 1973.
The latest form for Complaint of Discrimination Under Section 504, Section 508 or Title VI expires 2022-06-30 and is listed under ICR 201905-1405-005.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Form DS4282 Discrimination Complaint Form | Form and Instruction |
 Legal Authorities DS-4282 1405-0220.docx (document unavailable) | Supplementary Document |
 Final DS-4282 Supporting Statement 6-12-2019.docx | Supporting Statement A |
 Discrimination Complaint Form |
Form and Instruction |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 201905-1405-005 | Revision of a currently approved collection | 2019-05-09 | Approved with change | |
| 201603-1405-005 | New collection (Request for a new OMB Control Number) | 2016-03-24 | Approved with change | |
| 201512-1405-002 | New collection (Request for a new OMB Control Number) | 2015-12-08 | Comment filed on proposed rule | |
| 201507-1405-005 | New collection (Request for a new OMB Control Number) | 2015-07-30 | Comment filed on proposed rule |