Child and Adult Care Food Program

In accordance with federal civil rights law and U.S. Department of Agriculture (USDA)
civil rights regulations and policies, this institution is prohibited from discriminating on
the basis of race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity.
Program information may be made available in languages other than English.

Persons with disabilities who require alternative means of communication to obtain program
information (e.g., Braille, large print, audiotape, American Sign Language), should
contact the responsible state or local agency that administers the program or USDA’s
TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal
Relay Service at (800) 877-8339.

To file a program discrimination complaint, a Complainant should complete a Form AD-
3027,USDA Program Discrimination Complaint Form which can be obtained online at: https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Complaint-Form-0508-0002-508-11-28-17Fax2Mail.pdf, from any USDA office, by calling (866) 632-
9992, or by writing a letter addressed to USDA. The letter must contain the
complainant’s name, address, telephone number, and a written description of the alleged
discriminatory action in sufficient detail to inform the Assistant Secretary for Civil
Rights (ASCR) about the nature and date of an alleged civil rights violation. The
completed AD-3027 form or letter must be submitted to USDA by:

Mail:
U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250–9410; or

Fax:
(833) 256–1665 or (202) 690–7442; or

Email:
program.intake@usda.gov