File a Fair Housing Discrimination Complaint anywhere in the State of Florida

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INTERNET INTAKE FORM

If you feel have been the victim of housing discrimination in the sale or rental of housing or denied a mortgage loan or homeowners insurance within the last two years based on any of the following reasons, you may file a housing discrimination complaint.  Please fill in the form below.

Your First Name
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Your Last Name
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Your Address
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City
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Zipcode
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Telephone
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Your Email Address
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Date Discrimination Occurred
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Additional Information
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