City of Sunny Isles Beach

ylondono@sibfl.net

18070 Collins Avenue, 4th Floor, Sunny Isles Beach, FL 33160

305.792.1809

Translate

City of Sunny Isles Beach

18070 Collins Avenue

Sunny Isles Beach, FL 33160

305.792.1807

Title VI Complaint of Discrimination

Phone Number:

Email:

Please list the names, addresses and phone numbers of any witnesses:

Location of Incident:

Date of Incident:

Please explain how, why and where you believe you were discriminated against. Include as much background information as possible about the alleged acts of discrimination.

Complainant Signature:

First Name

Last Name

Choose how to sign

Draw Type

I agree to electronically sign and to create a legally binding contract between the other party and myself, or the entity I am authorized to represent.

Today's Date:

Note: Alternate means of filing complaint, such as personal interviews or a tape recording of the complain, will be made available for persons with disabilities upon request.