Grievance Complaint Form

Americans with Disabilities Act (ADA) Title II Complaint Form

Purpose: Use this form to file a complaint if you believe the Tucson Airport Authority (TAA) has not provided adequate accommodation for a disability.

Instructions: You may submit the online form below, or you may download the form, print it, sign it and mail or fax to:

Tucson Airport Authority
Chris Wilt, ADA Coordinator
7005 South Plumer Avenue
Tucson, Arizona 85736
Fax Number (520) 573-8006

Complaint Information

Complainant First Name

Complainant Last Name

Address

City

State --None-- ** AB AK AL AR AZ BC CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MB MD ME MH MI MN MO MS MT NB NC ND NE NF NH NJ NM NS NT NV NY OH OK ON OR PA PE PQ RI SC SD SK TN TX UT VA VT WA WI WV WY YT

Zip Code

Home Phone (include area code)

Business Phone (include area code)

Person (other than Complainant) Alleging an ADA Violation

Complainant Name

Address

City

State

Zip Code

Home Phone (include area code)

Business Phone (include area code)

TAA Service, Program or Facility Allegedly in Violation

Date Alleged Violation Occured (05-17-2012)

Alleged Violation and Requested Remedy

Was the case filed with the Department of Justice? YesNo

If You Answered "Yes" to the Previous Question, Complete the Following

Agency or Court

Contact Person

Address

City

State

Zip Code

Phone (include area code)

Date Filed (05-17-2012)

Other Comments

Red fields are required.

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Please enter the 4 character string shown in the box above.

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NOTE: please be advised that TAA is obligated to comply with the Arizona Public Record Law, Statutes 39.101 - 39.221. Furnishing the requested information is voluntary, except that the failure to provide such information may result in our being unable to process your complaint.