Monday, December 26, 2011

Illinois Parking Program for Persons with Disabilities Abuse Complaint Form 2011

From Illinois Secretary of State's office, you are able to file the following information on-line at: https://www.ilsos.gov/ContactFormsWeb/disabilitiescomplaintform.html
###

Please complete this form to report alleged misuse or abuse of the Parking Program for Persons with Disabilities. The Secretary of State's office requires the complaint to be based on facts rather than suspicions. Remember that not all disabilities are apparent nor does every individual with a disability use a mobility device such as a cane, walker or wheelchair. Never confront any person you think may be abusing the program. If the situation requires immediate attention, please call your local police department.

Please check the applicable box(s):

Misuse/Abuse of:
Accessible Parking Spaces
Disability License Plates
Parking Placard

Parking Placard Number:
(*Required if Parking Placard box checked above)

Vehicle Illinois License Plates Number:
(*Required if Accessible Parking Spaces box checked above)

Date, Time, Location of the misuse/abuse: (address, city/town)


Briefly describe why you believe the person(s) is misusing/abusing
the Parking Program for Persons with Disabilities:


I hereby state that the information provide herein is true and correct to the best of my knowledge and belief. I submit this complaint as part of my request that the Illinois Secretary of State conduct an investigation based on these facts. I understand that I may be called upon to testify in criminal proceedings as a complaining witness. I also understand that any false statements may be subject to prosecution under perjury, false report or civil statutes. Under penalty of perjury the undersigned swears that the facts contained on this document are within their personal knowledge and are true and correct.

Your Contact Information

###

No comments:

Post a Comment