ACLU: American Civil Liberties Union of Ohio
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Complaint Form  

This form is designed to assist the ACLU in the evaluation of your grievance. Please be as specific and detailed as possible.  It is important that all questions be answered completely.

Unfortunately, our resources are limited. We take cases that raise significant constitutional or civil liberties issues and which impact others in the same situation.  We cannot take all cases offered us. We are unable to take many cases, even those concerning real injustices.  If your complaint is not pursued by our office, it does not mean it is without merit.  You may wish to consult our Legal Links for information on how to get other help.

If we need further information, we have your address and/or telephone number and can request any documents necessary.  We dispose of our files after six months.

Although we keep our files confidential, submitting cases via email is not a secure means of transmission. If you do not wish to submit your form via email, you may fill out the form, print it and mail it to:

ACLU of Ohio Intake Department
4506 Chester Ave.
Cleveland, OH 44103

     1. Complainant information
* First name
* Last name
* Address 1
Address 2
* City
* State
* Zip code
County
* Daytime telephone
Evening telephone
Email

     2. My complaint is against
Name
Agency
Address 1
Address 2
City
State
Zip code
County
Telephone
Email
May we contact this person? Yes No

     3. Date of situation giving rise to your complaint

     4. Witnesses or persons with information about your complaint
Name
Address
City
State
Zip code
County
Telephone
Email
May we contact this person? Yes No
Name
Address
City
State
Zip code
County
Telephone
Email
May we contact this person? Yes No

     5. Have you filed a complaint with any other agencies?
Yes No
  If yes, please describe in the following space and include dates
     6. If you are a prisoner or detainee who has a complaint  
     concerning the conditions of your confinement or detention,
     you must exhaust all grievance procedures before contacting
     us. If this is the case, please provide a detailed description of
     the grievance procedures you followed.
     7. Are you represented by an attorney in this matter?
Yes No
If so, please fill in the following:
Attorney's name
Agency
Address
City
State
Zip code
County
Telephone
Email

     8. Has a criminal or civil lawsuit been filed against you or on your
     behalf?
Yes No
If so, please provide
Case number
Case title
Date of filing
Court with jurisdiction
Judge
Opposing counsel
Current status of the case

     9. Complete description of complaint. Please describe IN DETAIL,
     in a brief summary, all the events that led you to file this
     complaint.

     10. State clearly what you would like the ACLU to do for you.

I understand that by accepting this complaint, the ACLU is not undertaking legal representation of me, and that the ACLU is not responsible for ensuring that any statute of limitations requirement is met in my case. I hereby authorize the ACLU to use this information in any manner it deems necessary.

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