File a complaint against discriminatory housing practices

If you feel you have been turned down for housing (sale or rental) or denied a mortgage loan or homeowners insurance within the last two years based on any of the following reasons, please complete the form below.

Race/ Color	Religon	Familial Status ?
National Origin	Sex	Marital Status ?
Disability	Age ?	Sexual Orientation ?

In addition, if you are in need of Predatory Lending counseling, fill out form below also.

Your Contact Information

Name		No of houshold members
Address
City		State
Zip		County
Home Phone		Cell Phone
Email

Housing Provider, Mortgate Lender or Insurance Company Information

Name
Address
City		State
Zip		County
Phone
Date act of discrimination occurred
Additional Information * No one will be contacted on your behalf without your permission.

MON - FRI 9 AM - 5 PM

PHONE: 1-877-910-FAIR(3247)

EMAIL:

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