Americans With Disabilities Act (ADA) Grievance Form

CDTFA-351 (S1) (1-04)
AMERICANS WITH DISABILITIES ACT
GRIEVANCE FORM
CALIFORNIA DEPARTMENT OF
TAX AND FEE ADMINISTRATION

INSTRUCTIONS

This is a printable form. Simply complete, print and send to:

California Department of Tax and Fee Administration
Equal Employment Opportunity Office, P.O. Box 942879
Sacramento, CA 94279-0051
Grievant Information
Person Alleging ADA Violation (if other than grievant)
CDTFA Service, Program, or Facility Allegedly in Violation