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2. Town of Oakland Discrimination on the Basis of Disability Complaint Form

   This form should be used by all persons who wish to file a complaint against the Town or its employees because of discrimination on the basis of disability. The completed form should be filed with the Town Clerk. Investigation of all complaints shall be handled in an expedited fashion.

4. Questions regarding the complaint procedure or the Town's policy on nondiscrimination on the basis of disability may be directed to Elise Hui at:
6. Physical Address

   Town of Oakland, 230 North Tubb Street, P.O. Box 98, Oakland, FL 34760

7. Email
   ehui@oaklandfl.gov
8. Phone
   (407) 656-1117
10. First and Last Name
11. Email Address
13. Mailing Address
15. Physical Address (if different than mailing)
17. City
18. State
19. Zip Code
21. Phone Number
23. Check if applicable:
25. Check if applicable:*

    1. Current Town of Oakland Employee
    2. Applicant for Town of Oakland Job
29. 1. Clearly describe your complaint or difficulty in detail:
31. 2. Time, date, and location of the incident(s):
33. 3. Names of any town employees who are involved or other witnesses (if known):
35. 4. Has this complaint been discussed with the responsible town employee or department?

    1. Yes
    2. No
37. 5. What remedy or corrective action is requested?
Leave This Blank:


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

    This field is not part of the form submission.

41. Submit

* indicates a required field