Fillable Ciudad de Round Rock ADA Formulario de Quejas (City of Round Rock, Texas)

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Ciudad de Round Rock ADA Formulario de Quejas (City of Round Rock, Texas)

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Ciudad de Round Rock
ADA Formulario de Quejas
Título II de americanos con incapacidades de la sección 504 de la ley de rehabilitación de 1973
Instrucciones: Por favor llene este formulario completamente. Firmar y enviar a la dirección en la parte
inferior de la página. No se procesaran formularios incompletos.
Nombre:
Dirección:
Ciudad:
Estado: Codigo Postal:
Teléfono: ( ) E‐mail:
Ubicación el Quejas
Dirección
:
Hora/Fecha:
Por favor proporcione una descripción complete de su queja (adjuntar páginas adicionales si es necesario):
Firma: Fecha:
Por favor regrese a: ADA Transition Plan Coordinator, 2008 Enterprise Drive, Round Rock, Texas 78664
Para uso de la oficina
Instalaciones fuera de la jurisdicción de la ciudad se remitirán a la entidad apropiada por la Cuidad de Round
Rock
File #: Date Received: Received By:
Notes:
Reviewer Name: Title: ADA Plan Coordinator
Signature: Date:
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Ciudad de Round Rock ADA Formulario de Quejas (City of Round Rock, Texas)

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Completed 16 July 2020

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