Complaint – Fair Housing Long Beach

Fair Housing Long Beach

HOUSING DISCRIMINATION COMPLAINT

If you feel that you are the victim of HOUSING DISCRIMINATION, please provide the following information.

If you are reporting FRAUD being committed by an owner, tenant, or other party involved with the Long Beach Housing Authority's programs, please complete a Fraud Report Form by clicking here.

Name of Victim of Discrimination *

First

Last

Victim's Address *

Address Line 1

Address Line 2

City

State

Zip Code

Victim's Email *

Email

Confirm Email

Victim's Phone *

Housing Discrimination Based Upon *

Name of Person Committing the Discrimination *

First

Last

Name of Business *

Business Address

Address Line 1

Address Line 2

City

State

Zip Code

Business Phone

Business Email *

Please describe the discrimination in detail *

Please provide any evidence that you may wish to include

Click or drag a file to this area to upload.