Town of Davie Form Center

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ADA Complainant Form

  1. Town of Davie

    8800 SW 36th Street

    Davie, Florida 33328

    Phone: 954-797-1000

    Fax: 954-797-1087

  2. Town of Davie
    Title VI and ADA Complaint of Discrimination
  3. Type of Discrimination
  4. 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.
  5. Note: Alternate means of filing complaint, such as a personal interviews or a tape recording of the complaint, will be made available for persons with disabilities upon request.
  6. Submit to:

    Evelyn Roig, Town Clerk

    ADA Coordinator

    Town of Davie

    8800 SW 36th Street

    Davie, Florida 33328

    Email: Evelyn_roig@davie-fl.gov

    Phone: 954-797-1000

    Fax: 954-797-1087

    TTY: 954-828-5520

    Florida Relay (Voice): 800-955-8770

    Florida Relay (TTY): 800-955-8771

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