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• For SNAP: To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at: https://www.usda.gov/sites/default/files/documents/ad-3027.pdf, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to: 1. mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights, Mail Stop 9410 1400 Independence Avenue S.W., Room 1330, South Building Washington, D.C, 20250 2. fax: (833) 256-1665 or (202) 690-7442; or 3. email: SM.OASCR.ProgramAdjudication@usda.gov

• To file a complaint of discrimination regarding a program receiving Federal financial assistance through the U.S. Department of Health and Human Services (HHS), write: HHS Director, Office of Civil Rights, Room 515-F, 200 Independence Avenue, S.W., Washington, D.C. 20201, or call (202) 619-0403 (voice) or (800) 537-7697 (TTY).

Individuals who feel they have been discriminated against may file a written or verbal complaint. Anyone contacted about a complaint should make every effort to obtain the following information from the complainant: • Name • Address • Telephone number or other means of contacting the complainant. • Name and location of office where the alleged discrimination took place. • The nature of the incident that led to the complaint. • The protected status (i.e., race, color, national origin, sex, age, religion, political beliefs, or disability) that the complainant believes was violated. • The names and contact information of the individuals who have knowledge of the discriminatory action. • The date of the alleged discriminatory action, or if continuing, the duration of such actions. 1440.20.05 DFR AND DISCRIMINATION COMPLAINTS

The DFR's responsibilities related to handling complaints of discrimination are listed below: • Civil Rights complaints are to be forwarded to the appropriate Regional Manager who will initiate the investigation. Complaints may be forwarded to the Regional Manager (RM) via telephone or the regional mailbox (email). • Any complaints determined to be a complaint of discrimination based on age are to be reported to the FNS Regional Office of Civil Rights (OCR) within 5 days of receipt. • The tracking of civil rights complaints will be managed by the SNAP Policy section.