Are You a

 Victim of

 Housing

Discrimination?

Fair Housing is Your Right!

If you have been denied your 

housing rights...you may have 

experienced unlawful discrimination.

U.S. Department of Housing and Urban Development
For Connecticut, Maine, Massachusetts, 

New Hampshire, Rhode Island, and Vermont:

NEW ENGLAND OFFICE

Fair Housing Hub

U.S. Dept. of Housing and Urban Development

Thomas P. O’Neill, Jr. Federal Building

10 Causeway Street, Room 321

Boston, MA 02222-1092

Telephone (617) 994-8320 or 1-800-827-5005

Fax (617) 565-7313 • TTY (617) 565-5453

E-mail: Complaints_office_01@hud.gov

For New Jersey and New York:

NEW YORK/NEW JERSEY OFFICE

Fair Housing Hub

U.S. Dept. of Housing and Urban Development

26 Federal Plaza, Room 3532

New York, NY 10278-0068

Telephone (212) 264-1290 or 1-800-496-4294

Fax (212) 264-9829 • TTY (212) 264-0927

E-mail: Complaints_office_02@hud.gov

For Delaware, District of Columbia, Maryland, 

Pennsylvania, Virginia, and West Virginia:

MID-ATLANTIC OFFICE 

Fair Housing Hub

U.S. Dept. of Housing and Urban Development

The Wanamaker Building

100 Penn Square East

Philadelphia, PA 19107

Telephone (215) 656-0663 or 1-888-799-2085

Fax (215) 656-3419 • TTY (215) 656-3450

E-mail: Complaints_office_03@hud.gov

For Alabama, the Caribbean, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee:

SOUTHEAST/CARIBBEAN OFFICE

Fair Housing Hub

U.S. Dept. of Housing and Urban Development

Five Points Plaza

40 Marietta Street, 16th Floor

Atlanta, GA 30303-2808

Telephone (404) 331-5140 or 1-800-440-8091

Fax (404) 331-1021 • TTY (404) 730-2654

E-mail: Complaints_office_04@hud.gov

For Illinois, Indiana, Michigan, Minnesota, 

Ohio, and Wisconsin:

MIDWEST OFFICE 

Fair Housing Hub

U.S. Dept. of Housing and Urban Development

Ralph H. Metcalfe Federal Building

77 West Jackson Boulevard, Room 2101

Chicago, IL 60604-3507

Telephone (312) 353-7776 or 1-800-765-9372

Fax (312) 886-2837 • TTY (312) 353-7143

E-mail: Complaints_office_05@hud.gov

WHERE TO MAIL YOUR FORM OR 

 INQUIRE ABOUT YOUR CLAIM

To file electronically, visit: www.hud.gov

For Arkansas, Louisiana, New Mexico, Oklahoma, and Texas:

SOUTHWEST OFFICE 

Fair Housing Hub

U.S. Dept. of Housing and Urban Development

801 North Cherry, 27th Floor

Fort Worth, TX 76102

Telephone (817) 978-5900 or 1-888-560-8913

Fax (817) 978-5876 or 5851 • TTY (817) 978-5595

E-mail: Complaints_office_06@hud.gov

For Iowa, Kansas, Missouri and Nebraska:

GREAT PLAINS OFFICE 

Fair Housing Hub

U.S. Dept. of Housing and Urban Development

Gateway Tower II

400 State Avenue, Room 200, 4th Floor

Kansas City, KS 66101-2406

Telephone (913) 551-6958 or 1-800-743-5323

Fax (913) 551-6856 • TTY (913) 551-6972

E-mail: Complaints_office_07@hud.gov

For Colorado, Montana, North Dakota, South Dakota, 

Utah, and Wyoming:

ROCKY MOUNTAINS OFFICE 

Fair Housing Hub

U.S. Dept. of Housing and Urban Development

1670 Broadway

Denver, CO 80202-4801

Telephone (303) 672-5437 or 1-800-877-7353

Fax (303) 672-5026 • TTY (303) 672-5248

E-mail: Complaints_office_08@hud.gov

For Arizona, California, Hawaii, and Nevada:

PACIFIC/HAWAII OFFICE 

Fair Housing Hub

U.S. Dept. of Housing and Urban Development

600 Harrison Street, Third Floor

San Francisco, CA 94107-1300

Telephone (415) 489-6524 or 1-800-347-3739

Fax (415) 489-6558 • TTY (415) 436-6594

E-mail: Complaints_office_09@hud.gov

For Alaska, Idaho, Oregon, and Washington:

NORTHWEST/ALASKA OFFICE 

Fair Housing Hub

U.S. Dept. of Housing and Urban Development

Seattle Federal Office Building

909 First Avenue, Room 205

Seattle, WA 98104-1000

Telephone (206) 220-5170 or 1-800-877-0246

Fax (206) 220-5447 • TTY (206) 220-5185

E-mail: Complaints_office_10@hud.gov

If after contacting the local office nearest you, you still have questions – you may contact HUD further at:

U.S. Dept. of Housing and Urban Development

Office of Fair Housing and Equal Opportunity

451 7th Street, S.W., Room 5204

Washington, DC 20410-2000

Telephone (202) 708-0836 or 1-800-669-9777

Fax (202) 708-1425 • TTY 1-800-927-9275
Public Reporting Burden for this collection of information is estimated to average 20 minutes per response, 

including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data 

needed, and completing and reviewing the collection of information.

The Department of Housing and Urban Development is authorized to collect this information 

by Title VIII of the Civil Rights Act of 1968, as amended by the Fair Housing Amendments Act of 

1988, (P.L. 100-430); Title VI of the Civil Rights Act of 1964, (P.L. 88-352); Section 504 of the Rehabilitation Act of 1973, as amended, (P.L. 93-112); Section 109 of Title I- Housing and Community

Development Act of 1974, as amended, (P.L. 97-35); Americans with Disabilities Act of 1990, (P.L. 101-336); and by the Age

Discrimination Act of 1975, as amended, (42 U.S.C. 6103).

T h e i n f o r m a t i o n w i l l b e u s e d t o i n v e s t i g a t e a n d t o p r o c e s s h o u s -

i n g d i s c r i m i n a t i o n c o m p l a i n t s . T h e i n f o r m a t i o n m a y b e d i s c l o s e d t o 

the United States Department of Justice for its use in the filing of pattern and pract i c e s u i t s o f h o u s i n g d i s c r i m i n a t i o n o r t h e p r o s e c u t i o n o f t h e p e r s o n ( s ) 

who committed that discrimination where violence is involved; and to State or local fair housing agencies that

a d m i n i s t e r s u b s t a n t i a l l y e q u i v a l e n t f a i r h o u s i n g l a w s f o r c o m -

p l a i n t p r o c e s s i n g . F a i l u r e t o p r o v i d e s o m e o r a l l o f t h e r e q u e s t e d

information will result in delay or denial of HUD assistance.

Disclosure of this information is voluntary.

MAIL TO:

PLACE

POSTAGE

HERE
1

Instructions: (Please type or print) Read this form carefully. Try to answer all questions. If you do not know 

the answer or a question does not apply to you, leave the space blank. You have one year from the date of the alleged 

discrimination to file a complaint. Your form should be signed and dated. 

Your Name

Your Address

City State Zip Code

Best time to call Your Daytime Phone No Evening Phone No

Who else can we call if we cannot reach you?

Contact’s Name Best Time to call

Daytime Phone No Evening Phone No

Contact’s Name Best Time to call

Daytime Phone No Evening Phone No

What happened to you?

How were you discriminated against? 1For example: were you refused an opportunity to rent or buy housing? Denied a loan? Told that housing was not available when in fact it was? Treated differently from others seeking housing? 

State briefly what happened.

Form HUD-903.1 (1/02) OMB Approval No. 2529-0011 (exp. 1/31/2011)

HOUSING DISCRIMINATION INFORMATION

Departamento de Vivienda y Desarrollo Urbano Oficina de Derecho Equitativo a la Vivienda

U.S. Department of Housing and Urban Development Office of Fair Housing and Equal Opportunity
2

Why do you think you are a victim of housing discrimination?

Is it because of your:

• race • color • religion • sex • national origin • familial status (families with children under 18) • disability? 2 For example: were you denied housing because of your race? Were you denied a mortgage loan because of your 

religion? Or turned down for an apartment because you have children? 

Briefly explain why you think your housing rights were denied and circle the factor(s) listed above that you believe 

apply.

3

4

5

Who do you believe discriminated against you?

For example: was it a landlord, owner, bank, real estate agent, broker, company, or organization?

Identify who you believe discriminated against you.

Name

Address

Where did the alleged act of discrimination occur?

For example: Was it at a rental unit? Single family home? Public or Assisted Housing? A Mobile Home? 4Did it occur at a bank or other lending institution?

Provide the address.

Address

City State Zip Code

When did the last act of discrimination occur? 5Enter the date

Is the alleged discrimination continuing or ongoing? Yes No

Send this form to HUD or to the fair housing agency nearest you. If you are unable to complete this form, you may 

call that office directly. See address and telephone listings on back page.

/ / 

Signature Date

HOUSING DISCRIMINATION INFORMATION

Departamento de Vivienda y Desarrollo Urbano Oficina de Derecho Equitativo a la Vivienda

U.S. Department of Housing and Urban Development Office of Fair Housing and Equal Opportunity
It is Unlawful to Discriminate in Housing Based on These Factors...

• Race

• Color

• National origin

• Religion

• Sex

• Familial status (families with children under the age of 18, 

or who are expecting a child) 

• Handicap (if you or someone close to you has a disability)

If You Believe Your Rights Have Been Violated...

• HUD or a State or local fair housing agency is ready to help you 

file a complaint.

• After your information is received, HUD or a State or local fair housing agency will 

contact you to discuss the concerns you raise.

If you have not heard from HUD or a State or local fair housing agency within three weeks from the date 

you mailed this form, you may call to inquire about the status of your complaint. See address and telephone listings on back page.

Keep this information for your records.

Date you mailed your information to HUD: 

Address to which you sent the information:

Offi ce Telephone

Street

City State Zip Code

/ / 

! Detach here. Fold and close with glue or tape (no staples)
Under the Fair Housing Act, it is Against the Law to:

• Refuse to rent to you or sell you housing

• Tell you housing is unavailable when in fact it is

 available

• Show you apartments or homes only in certain

 neighborhoods

• Set different terms, conditions, or privileges for sale or rental of a 

dwelling

• Provide different housing services or facilities

• Advertise housing to preferred groups of people only

• Refuse to provide you with information regarding

 mortgage loans, deny you a mortgage loan, or impose different 

terms or conditions on a mortgage loan

• Deny you property insurance

• Conduct property appraisals in a discriminatory manner

• Refuse to make reasonable accomodations for persons with a 

disability if the accommodation may be necessary to afford such 

person a reasonable and equal opportunity to use and enjoy a 

dwelling.

• Fail to design and construct housing in an accessible manner

• Harass, coerce, intimidate, or interfere with anyone

exercising or assisting someone else with his/her fair housing 

rights

HOW DO YOU RECOGNIZE HOUSING DISCRIMINATION? UndLaw to:

ARE YOU A VICTIM OF HOUSING DISCRIMINATION?

“The American Dream of having a safe and decent place to call ‘home’ 

reflects our shared belief that in this nation, opportunity and 

success are within everyone’s reach.

Under our Fair Housing laws, every citizen is assured the

opportunity to build a better life in the home or apartment of their 

choice — regardless of their race, color, religion, sex, national origin, 

family status or disability.”

Alphonso Jackson

Secretary