Title II of the Americans with Disabilities Act of 1990/Section 504 Rehabilitation Act of 1973 Discrimination Compliant Form

Title II of the Americans with Disabilities Act of 1990/Section 504 Rehabilitation Act of 1973 Discrimination Complaint Form

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1190-0009 can be found here:

Documents and Forms

Document Name Document Type
Form 1190-0009 Title II of the Americans with Disabilities Act of 1990/Section 504 Rehabilitation Act of 1973 Discrimination Compliant Form Form
1190-0009 ADA Title II/Section 504 Compliant Form Title II Complaint Form.mht www.usdoj.gov/crt/ada/t2cmpfrm.htm Form

Information Collection (IC) Details

IC Title:	Title II of the Americans with Disabilities Act of 1990/Section 504 Rehabilitation Act of 1973 Discrimination Compliant Form	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 28 CFR 35

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1190-0009	ADA Title II/Section 504 Compliant Form	Title II Complaint Form.mht	http://www.usdoj.gov/crt/ada/t2cmpfrm.htm	Yes	No	Printable Only

Line of Business: Litigation and Judicial Activities

Subfunction: Legal Prosecution and Litigation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 5,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Previously Approved
Annual Number of Responses for this IC	5,000	5,000
Annual IC Time Burden (Hours)	3,750	3,750
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.