By signing this complaint, I am authorizing the CDSS Civil Rights Bureau (CRB) to reveal my identity and other personal information to persons at the organization or institution under …
On-line Forms and Publications E - H - California Dept. of Social …
GEN 727B (5/19) - County Forms Order, with Instructions Do NOT download this file to your computer if you want to use it to order online - open the file within your web browser. You …
Submitting a Discrimination Complaint - Department of Public …
All public facing offices have the PA 607 or GEN 1179 available. You may email the completed PA 607 or GEN 1179 to [email protected]. You may fax the completed PA …
gen 1179 (sp) (9/12) fecha fecha en que ocurriÓ lugar donde ocurriÓ y nombre de la oficina/agencia nombre direcciÓn clase de asistencia nÚmero del caso nÚmero de telÉffono ( …
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GEN 1179.pdf
GEN 1179 (9/12) DATE DATE OF OCCURRENCE PLACE OF OCCURRENCE AND AGENCY NAME ADDRESS AID TYPE CASE NUMBER PHONE NUMBER ( ) Title: GEN 1179.pdf …
Your Civil Rights, Appeals, and Hearings | sfhsa.org
Fill out form GEN 1179: English | 中文 | Español | Tagalog | русский | Tiếng Việt. Mail the form to SFHSA Office of Civil Rights, P.O. Box 7988, San Francisco, CA 94120-7988 ; Or, fax the …
Presentar una Queja por Discriminación - Department of Public …
Puede enviar el PA 607 o GEN 1179 completo a un empleado del DPSS en cualquier oficina del DPSS. Todas las oficinas de cara al público tienen disponible el PA 607 o el GEN 1179. Por …
Form GEN1179 Complaint of Discrimination - California
2018年5月1日 · Download Fillable Form Gen1179 In Pdf - The Latest Version Applicable For 2025. Fill Out The Complaint Of Discrimination - California Online And Print It Out For Free.
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The Complaint of Discrimination (GEN 1179) form shall be used to file a Civil Rights complaint with Colusa County at the following address:
Russian A-M - California Dept. of Social Services
GEN 111 (11/20) - Employer Statement Form; GEN 853 (10/20) - Sworn Statement; GEN 1179 (5/18) - Complaint of Discrimination ; GEN 1388 (9/15) - Language Accessibility Services …
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