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Grievance Procedure under the Americans with Disabilities Act
Pursuant to the Americans with Disabilities Act of 1990 (ADA), the City of Allen (“The City”) is providing this Grievance Procedure and associated forms to any persons wishing to file a complaint alleging discrimination by The City. Grievances may be filed on the basis of disability in the provision of services, activities, programs, or benefits by the City of Allen. The City of Allen accepts employment-related complaints through its Personnel Policy, under separate cover.

The complaint must be in writing and contain information about the alleged discrimination including name, address, phone number of complainant and location, date, and description of the problem. Alternative means of filing complaints for any person with disabilities that hinder written submission will be made available upon request. Some alternate forms of documenting a complaint may include personal interviews or a tape recording of the complaint. The alternate form of documentation will then be transcribed by City Staff to record the concern. The attached form can also be used to file complaints.

The complainant and/or their designee, hereinafter referred to as Complainant, should submit the complaint as soon as possible, but no later than 60 calendar days after the alleged violation to:

City of Allen ADA Coordinator
City of Allen Human Resources Department
305 Century Parkway
Allen, TX 75013

Within 15 business days after receipt of the complaint, the City of Allen ADA Coordinator or their designee, hereinafter referred to as ADA Coordinator, will contact the Complainant to discuss the complaint and the possible resolution. The discussion could take place by meeting in person, by phone or other means. Within 15 business days of that discussion, the ADA Coordinator will respond in writing, and as needed, in a format accessible to the Complainant, such as large print, braille, or audio recording. The response will explain the position of the City of Allen and offer any possible option(s) for substantive resolution of the complaint, if they exist.

The Complainant may appeal the decision from the ADA Coordinator to the City Manager. The appeal shall be filed with the City Manager’s Office within 15 business days after receipt of the response from the ADA Coordinator. The City Manager or designee, at his/her discretion, may meet with Complainant in person to discuss reconsideration of the issue. In the absence of an appeal within this timeframe, the initial response from the ADA Coordinator will be deemed accepted.

Should Complainant file an appeal to the City Manager, within 15 business days after receiving the appeal notification, the City Manager will respond in writing, and as needed, in a format accessible to the Complainant, with a final decision on the complaint.

The Complainant may appeal to the Department of Justice (DOJ) if the final decision from the City Manager is not deemed acceptable by the Complainant. The Complainant is then responsible for contacting, receiving, and providing any communications regarding the complaint to and from the DOJ.

All written complaints received by the City of Allen ADA Coordinator, appeals to the City Manager, and responses from these two offices will be retained by the City of Allen for three years from the date of the final resolution or dismissal of the complaint.
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Title II of the Americans with Disabilities Act Section 504 of the Rehabilitation Act of 1973 Discrimination Complaint Form
Please fill out this form completely. Sign and return to the ADA Coordinator.
Printable ADA Discrimination Form
Blank ADA Discrimination Form
If you prefer to print out the form and type or hand-write your responses, please use the above link to download a blank version.
Complaint Information
Name
Address
City
State
Zip Code
Home Telephone
Business or Alternate Phone
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Section 2

City of Allen department, program, service, organization, or building which you believe caused discrimination:
Name
Address
City
State
Zip Code
Telephone No.
Secondary Telephone No.
Date
When did the discrimination occur?
Describe the act of discrimination providing the name(s) where possible of the individual(s) who discriminated:
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Section 3

Has the complaint been filed with a bureau of the Department of Justice or any other Federal, State, or local civil rights agency or court?
1. Yes
1. No
If yes, Agency or Court?
Contact Person
Address
City
State
Zip Code
Telephone No.
Secondary Telephone No.
Date Filed
Do you intend to file with another agency or court?
1. Yes
1. No
If yes, Agency or Court?
Address
City
State
Zip Code
Telephone No.
Secondary Telephone No.
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Digital Signature Block

Signature
Please type your full name.
Signature Verification
1. Complainant
1. Complainant's Designee
Please indicate if the signature on this form is from the Complainant or the Complainant's Designee.
Digital Signature Agreement*
1. Digital Signature
1. Manual Signature
By clicking above button, you are verifying your digital signature. If you choose "manual," please select the submit and print option and return your signed to copy to the address listed below.
By clicking "submit," you acknowledge that your form will be submitted to the City of Allen ADA Coordinator. If you elect to provide a manual signature, please print this form and return it to:
City of Allen ADA Coordinator
City of Allen Human Resources Department
305 Century Parkway
Allen, TX 75013

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1. Receive an email copy of this form.
Email address

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Grievance Procedure under the Americans with Disabilities Act

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