OMB control number
Complaint of Discrimination Under Section 504, Section 508 or Title VI
OMB 1405-0220 · STATE/AFA.
OMB 1405-0220
The DS-4282 will be used to submit complaints of discrimination under Title VI of the Civil Rights Act of 1964; and Sections 504 and 508 of the Rehabilitation Act of 1973.
The latest form for Complaint of Discrimination Under Section 504, Section 508 or Title VI expires 2022-06-30 and can be found here.
Latest Forms, Documents, and Supporting Material
Document Name |
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Form and Instruction |
 Legal Authorities DS-4282 1405-0220.docx (document unavailable) Supplementary Document |
Supporting Statement A |
Form DS4282 Discrimination Complaint Form
Final DS-4282 Supporting Statement 6-12-2019.docx
Discrimination Complaint Form All Historical Document Collections
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Approved with change |
Revision of a currently approved collection | 2019-05-09 | |
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Approved with change |
New collection (Request for a new OMB Control Number) | 2016-03-24 | |
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Comment filed on proposed rule |
New collection (Request for a new OMB Control Number) | 2015-12-08 | |
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Comment filed on proposed rule |
New collection (Request for a new OMB Control Number) | 2015-07-30 |