Complaint of Discrimination Under Section 504, Section 508 or Title VI

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 can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form DS4282 Discrimination Complaint Form Form and Instruction
Legal Authorities DS-4282 1405-0220.docx Supplementary Document
Final DS-4282 Supporting Statement 6-12-2019.docx Supporting Statement A
Discrimination Complaint Form Form and Instruction

All Historical Document Collections

201905-1405-005 Approved with change	Revision of a currently approved collection	2019-05-09
201603-1405-005 Approved with change	New collection (Request for a new OMB Control Number)	2016-03-24
201512-1405-002 Comment filed on proposed rule	New collection (Request for a new OMB Control Number)	2015-12-08
201507-1405-005 Comment filed on proposed rule	New collection (Request for a new OMB Control Number)	2015-07-30