Fair Housing Complaint Form

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Your Information


Offending Party Information

Please provide information about the person(s) who you believe discriminated against you.

Respondent 1

Respondent 2

Respondent 3

Respondent 4

Incident Information

What is the basis of the alleged discrimination, harassment or retaliation?

Select all that apply

Name the people who were involved and what they did to discriminate against you. Please include the names of any witnesses. Feel free to attach this information as a separate document in the Additional Information section.
Have you filed this complaint anywhere else?
e.g. Maryland Commission on Civil Rights, HUD, etc.

Additional Information

You may attach a document with information that you think is relevant to your complaint.


e.g. interpreter services, audio instructions, etc.


By signing my name below, I affirm that I have read the above charge(s) and that it is true to the best of my knowledge, information and belief.