2000C - Disability Access Complaint

Consumer Information

    (Complete only if you are filing this complaint on behalf of a company or an organization.)

    (Official Post Office Box Number Only)
Mailing Address (where mail is delivered)

 


Telephone Number (Residential or Business): )- -  
Are you filing information on behalf of another party, such as client, parent, spouse or roommate?
IMPORTANT: Please indicate the preferred format or method of response to the complaint by the Commission
and defendant:

Form 2000C - Disability Access Complaint

*** ANSWER EACH QUESTION THAT APPLIES TO YOUR SPECIFIC COMPLAINT ***
1.
Check the appropriate box for your type of complaint:
Telecommunications Relay Service (TRS) (for example, TTY-based, IP Relay, CapTel, IP CapTel, Speech-to-Speech, VideoRelay Service (VRS))
2.
Provide the name, address and telephone number (if known) of the company(s) involved in your complaint:
  • ( ) - -
3.
4.
If your complaint is about closed captioning or emergency information on television, provide the date (mm/dd/yyyy)
Character Count:0    (1,000 Characters max)
5.
If your complaint is about access to emergency information on television, provide the following information:
  1. Station or subscription TV provider system location:
  2. Date(s) and time(s) of emergency (mm/dd/yyyy): and time

  3. Character Count:0    (1,000 Characters max)
6.
If your complaint is about video description or closed captioning on television, provide the following:
  1. Station or subscription TV provider system location:



7.
If your complaint is about closed captioning of television programs streamed or downloaded from the Internet,
provide the following information:
  1. Date (mm/dd/yyyy): and time the program was viewed.
8.
Character Count:0    (1,000 Characters max)
ATTACH FILES:  How do you want to attach files related to this complaint?