Questionnaire


Employment Discrimination
Wage/Pay Issues
Housing Discrimination
Education Issues
Consumer and Fraud Issues (excessive fees, predatory lending, deceptive billing practices, false and misleading advertising)
Law Enforcement Issues (racial profiling, unlawful arrest, excessive force)
Other

Release of Liability:

I affirm that the statements I have made above are accurate and true to the best of my knowledge and belief. I hereby request the assistance of the NAACP in seeking remedy of the situation described above. I hereby authorize the officers and executive committee of the NAACP to have access to information and documents which are relevant to my claim of discrimination described above.

I understand that once a referral to a volunteer, community agency or private attorney has been made, the NAACP WILL NOT BE RESPONSIBLE for handling this matter. In fact, I further understand that by signing this document, I am agreeing to HOLD THE NAACP harmless of any and all damages arising as a result of my case being mishandled, negligently handled or improperly handled in any way.

Completing this form does not constitute filing an official complaint with a legal authority. At this time the NAACP is only seeking information to assist you concerning this complaint.

 

PLEASE KEEP THIS INFORMATION CONFIDENTIAL

Contact Details

Greater Sacramento NAACP Branch 1060.
3555 3rd Avenue
Sacramento, CA 95817 (Inside WCIC)

916.856.0155

secnaacp1060@gmail.com

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