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ADA Grievance Appeal Form

  1. City of Sultan - ADA Grievance Form
  2. Preferred Contact Method to discuss grievance
  3. Electronic Signature Agreement
    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.
  4. Return to: City of Sultan, Tami Pevey, ADA Coordinator/City Clerk, 319 Main Street, P.O. Box 1199, Sultan, WA 98294, or email to adacoordinator@ci.sultan.wa.us.

    Upon request, reasonable accommodation will be provided in completing this form, or copies of the form will be provided in alternative formats. Contact Tami Pevey, ADA Coordinator/City Clerk, 319 Main Street, P.O. Box 1199, Sultan, WA 98294, or email adacoordinator@ci.sultan.wa.us, or call 360-793-1811 (dial -7-1-1 for Washington State Relay Services).

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