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Civil Rights Complaint Procedure and Form

Civil Rights Complaint Procedure

United States Department of Agriculture (USDA)/Food and Nutrition Service (FNS) Instruction 113-1(dated 11/8/05) delineates the civil rights requirements for participants in Child Nutrition Programs.

Accepting a Complaint

Civil rights complaints are directed to: Amy Maclosky, Director, Office of Food and Nutrition Services, 2110 Washington Blvd, 鶹, VA 22204, Office: 703.228.2621, amy.maclosky@apsva.us
Complaints can be received verbally, in writing or anonymously and within 90 days of the alleged discriminatory action. ().

Transcribing a Complaint

Complaints will be processed within 90 days. The following information will be collected (verbally, inwriting or anonymously): name, address, and telephone number of the complainant, the nature of the incident or action that led the complainant to feel discrimination was a factor, the basis on which the complainant believes discrimination exists, the names, telephone numbers, titles, and business or personal addresses of persons who may have knowledge of the alleged discriminatory action, and the date(s) during which the alleged discriminatory action occurred.

Forwarding a Complaint

Complaints will be forwarded to: VDOE Office of School Nutrition Programs, PO BOX 2120 Richmond, VA 23218-2120


In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity.

Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDAs TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.

To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at: , from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainants name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to USDA by:

  1. mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW Washington, D.C. 20250-9410; or
  2. fax: (833) 256-1665 or (202) 690-7442; or
  3. email:

This institution is an equal opportunity provider.