Online Complaint Hud Form PDF Details

The U.S. Department of Housing and Urban Development (HUD) is committed to ensuring fair housing for all individuals, irrespective of race, color, national origin, religion, sex, familial status, or handicap. At the heart of this commitment is the HUD Complaint form, a critical tool designed to empower victims of housing discrimination. This form, identified by its OMB Approval No. 2529-0011 and set to expire on 4/30/98, is directly accessible through the Office of Fair Housing and Equal Opportunity. It serves as a formal avenue for individuals to report experiences of housing discrimination, encompassing a wide range of prohibited practices. These include refusal to rent or sell housing, falsely claiming that housing is unavailable, imposing discriminatory conditions on mortgage loans, and engaging in harassment or intimidation based on an individual's protected status. Importantly, the form encourages victims to act within one year from the date of the alleged discriminatory act, facilitating a process where HUD or a State or local fair housing agency can assist in addressing grievances. By delving into specific incidents of discrimination, including the who, what, when, and where, the HUD-903.1 form stands as a beacon of hope for those denied their rightful access to housing, underscoring the federal government's role in promoting an inclusive and equitable housing market.

QuestionAnswer
Form NameOnline Complaint Hud Form
Form Length6 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 30 sec
Other namesfair housing complaint form pdf, hud 903 complaint form pdf, hud 903 1, hud form 903

Form Preview Example

OMB Approval No. 2529-0011 (exp. 4/30/98)

U.S. Department of Housing and Urban Development

Office of Fair Housing andEqual Opportunity

AreyouofaVictim

Housing

Discrimination?

Fair Housing is Your Right!

If you have been denied your housing rights ... you may have experienced housing discrimination.

form HUD-903.1 (11/97)

How do you recognize Housing Discrimination?

Under the Fair Housing Act, It is Against the Law to:

Refuse to rent to you or sell you housing

Tell you housing is unavailable when in fact it is available

Show you apartments or homes in certain neighborhoods only

Advertise housing to preferred groups of people only

Refuse to provide you with information regarding mortgage loans, deny you a mortgage loan, or impose different terms or conditions on a mortgage loan

Deny you property insurance

Conduct property appraisals in a discriminatory manner

Refuse to make certain modifications or accommodations for persons with a mental or physical disability, including persons recovering from alcohol and substance abuse, and HIV/AIDS-related illnesses

Fail to design and construct housing in an accessible manner

Harass, coerce, intimidate, or interfere with anyone exercising or assisting someone else with their fair housing rights

Based on these factors...

Race

Color

National origin

Religion

Sex

Familial status (families with children under the age of 18, or who are expecting a child), or

Handicap (if you or someone close to you has a disability)

If you don't report discrimination, it can't be stopped!

Housing Discrimination Information Form

If you believe your rights have been violated, HUD or a State or local fair housing agency is ready to help you file a complaint.

You have one year from the date of the alleged act of discrimination to file your complaint.

After your information is received, we will contact you to discuss the concerns you raise.

Instructions: (Please type or print.) Read this form carefully. Try to answer all questions. If you do not know the answer or a question does not apply to you, leave the space blank. You have one year from the date of the alleged discrimination to file a complaint. Your form should be signed and dated. Use reverse side of this page if you need more space to respond.

Keep this information for your records.

Date you mailed your information to HUD:

Address to which you sent the information:

Street:

City:

State:

Zip Code:

If you have not heard from HUD or a fair housing agency within three weeks from the date you mail this form, you may call to inquire about the status of your complaint. See addresses and telephone listings on the last page.

Your Name:

 

Best time

 

Your Daytime Phone No:

 

 

to call:

 

 

 

 

 

 

 

Your Address:

 

 

 

Evening Phone No:

 

 

 

 

 

City:

 

State:

 

Zip Code:

 

 

 

 

 

 

 

Who else can we call if we cannot reach you?

1 Contact's Name:

Daytime Phone No:

Best time to call:

Evening Phone No:

2Contact's Name:

Daytime Phone No:

Best time to call:

Evening Phone No:

1.What happened to you? How were you discriminated against? For example: were you refused an opportunity to rent or buy housing? Denied a loan? Told that housing was not available when in fact it was? Treated differently from others seeking housing? State briefly what happened.

2.Why do you believe you are being discriminated against?

It is a violation of the law to deny you your housing rights for any of the following factors:

race color religion sex national origin familial status (families with children under 18) disability.

For example: were you denied housing because of your race? Were you denied a mortgage loan because of your religion? Or turned down for an apartment because you have children? Were you harassed because you assisted someone in obtaining their fair housing rights? Briefly explain why you think your housing rights were denied because of any the factors listed above.

3.Who do you believe discriminated against you? Was it a landlord, owner, bank, real estate agent, broker, company, or organization?

Name:

Address:

4.Where did the alleged act of discrimination occur? Provide the address. For example: Was it at a rental unit? Single family home? Public or Assisted Housing? A Mobile

Home? Did it occur at a bank or other lending institution?

Address:

City:

State:

Zip Code:

5.When did the last act of discrimination occur? Enter the date _____/_____/_____

Is the alleged discrimination continuous or on going?

Yes

No

Signature:

Date:

X

Send this form to HUD or to the fair housing agency where the alleged act of discrimi- nation occurred.

If you are unable to complete this form, you may call the office nearest you. See addresses and telephone numbers listed on the back page.

Privacy Act Statement The Department of Housing and Urban Development is authorized to collect this information by Title VIII of the Civil Rights Act of 1968, as amended by the Fair Housing Amendments Act of 1988, (P.L. 100-430); Title VI of the Civil Rights Act of 1964, (P.L. 88-352); Section 504 of the Rehabilitation Act of 973, as amended, (P.L. 93-112); Section 109 of Title I - Housing and Community Development Act of 1974, as amended, (P.L. 97-35); Americans with Disabilities Act of 1990, (P.L. 101-336); and by the Age Discrimination Act of 1975, as amended, (42 U.S.C. 6103).

The information will be used to investigate and to process housing discrimination complaints. The information may be disclosed to the United States Department of Justice for its use in the filing of pattern and practice suits of housing discrimination or the prosecution of the person(s) who committed the discrimination where violence is involved; and to State or local fair housing agencies that administer substantially equivalent fair housing laws for complaint processing. Failure to provide some or all of the requested information will result in delay or denial of HUD assistance.

Public Reporting Burden for this collection of information is estimated to average 20 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

Disclosure of this information is voluntary.

For Connecticut, Maine,

For Illinois, Indiana, Michigan,

For Colorado, Montana, North

Massachusetts, New

Minnesota, Ohio, and

Dakota, South Dakota, Utah,

Hampshire, Rhode Island, and

Wisconsin:

and Wyoming:

Vermont:

Fair Housing Enforcement Center

Fair Housing Enforcement

Fair Housing Enforcement Center

U.S. Department HUD

Center

U.S. Department HUD

Ralph H. Metcalfe Federal Bldg.

U.S. Department HUD

10 Causeway Street, Room 321

77 West Jackson Boulevard,

633 17th Street

Boston, MA 02222-1092

Room 2101

Denver, CO 80202-3607

(617) 565-5308

Chicago, IL 60604-3507

(303) 672-5437

1-800-827-5005

(312) 353-7776

1-800-877-7353

TTY (617) 565-5453

1-800-765-9372

TTY (303) 672-5248

For New Jersey and New York:

TTY (312) 353-7143

For Arizona, California,

 

Fair Housing Enforcement Center

For Arkansas, Louisiana, New

Hawaii, and Nevada:

U.S. Department HUD

Mexico, Oklahoma, and Texas:

Fair Housing Enforcement Center

26 Federal Plaza, Room 3532

Fair Housing Enforcement Center

U.S. Department HUD

New York, NY 10278-0068

U.S. Department HUD

Phillip Burton Federal Building

(212) 264-9610

1600 Throckmorton, Room 502

and U.S. Courthouse

1-800-496-4294

Forth Worth, TX 76113-2905

450 Golden Gate Avenue

TTY (212) 264-0927

(817) 978-9270

San Francisco, CA 94102-3448

For Delaware, District of

1-800-498-9371

(415) 436-8400

TTY (817) 978-9274

1-800-347-3739

Columbia, Maryland,

 

TTY (415) 436-6594

Pennsylvania, Virginia, and

For Iowa, Kansas, Missouri

 

West Virginia:

and Nebraska:

For Alaska, Idaho, Oregon,

Fair Housing Enforcement Center

Fair Housing Enforcement Center

and Washington:

U.S. Department HUD

U.S. Department HUD

Fair Housing Enforcement Center

The Wanamaker Building

Gateway Tower II

U.S. Department HUD

100 Penn Square East

400 State Avenue, Room 200

Seattle Federal Office Building

Philadelphia, PA 19107-3380

Kansas City, KA 66101-2406

909 First Avenue, Room 205

(215) 656-0660

(913) 551-6958

Seattle, WA 98104-1000

1-888-799-2085

1-800-743-5323

(206) 220-5170

TTY (215) 656-3450

TTY (913) 551-6972

1-800-877-0246

For Alabama, the Caribbean,

 

TTY (206) 220-5185

 

 

Florida, Georgia, Kentucky,

 

 

Mississippi, North Carolina,

 

 

South Carolina, and Tennessee:

 

 

Fair Housing Enforcement Center

 

 

U.S. Department HUD

 

 

Richard B. Russell Federal Bldg.

 

 

75 Spring Street, SW, Room 230

 

 

Atlanta, GA 30303-3388

 

 

(404) 331-5140

 

 

1-800-440-8091

 

 

TTY (404) 730-2654