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§ 10A:1-3.7. Americans with Disabilities Act Grievance Form 100
The following Americans with Disabilities Act Grievance Form 100 may be utilized for the submission of a grievance pursuant to this subchapter:
Americans with Disabilities Act Grievance Form 100 |
Date: ____________________________________________
Name of grievant: __________________________________
Address of grievant: _______________________________
Telephone number of grievant: _______________________
Name, address and telephone number
of alternate contact person: ________________________
_________________________________________________
_________________________________________________
Agency alleged to have denied access:
Department: ______________________________________
Division: _________________________________________
Bureau or office: __________________________________
Location: ________________________________________
Incident or barrier: ________________________________
Please describe the particular way in which you believe you have been denied the benefits of any service, program or activity or have otherwise been subject to discrimination. Please specify dates, times and places of incidents, and names and/or positions of agency employees involved, if any, as well as names, addresses and telephone numbers of any witnesses to any such incident. Attach additional pages if necessary.
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
_________________________________________________
Proposed access or accommodation:
If you wish, describe the way in which you feel access may be had to the benefits described above, or that accommodation could be provided to allow access.
_________________________________________________
_________________________________________________
_________________________________________________
A copy of the above Form 100 may be obtained by contacting the designated ADA coordinator identified at 10A:1-3.4.
(Administrative change.Sep 15, 2017
Settlement
Camden County
Camden County, NJ
Jul 25, 2019
Transfer
Union County
Union County, NJ
Apr 27, 2022
Active
Hon. Darren J Delsardo
Passaic County
Passaic County, NJ
Mar 12, 2024
Active
Essex County
Essex County, NJ
Nov 02, 2021
Active
Essex County
Essex County, NJ
BUR-L-002227-16 11/27/2017 4:10:05 PM Pg 1 of 16 Trans ID: LCV2017533731 HANGLEY ARONCHICK SEGAL PUDLIN & SCHILLER Bonnie M. Hoffman (I.D. No. 022382005) Andrew M. Erdlen (I.D. No. 183952016) 20 Brace Road, Suite 201 Cherry Hill, NJ 08034-2634 Telephone: (856) 616-2100 Facsimile: (856) 616-2170 Counsel for Defendant Nobel Learning Communities, Inc., d/b/a Chesterbrook Academy : SUPERIOR COURT OF NEW JERSEY CRAIG…
BUR-L-002227-16 01/26/2018 4:00:23 PM Pg 1 of 3 Trans ID: LCV2018167286 20 Brace Road Suite 201 C…
a ATL-DC-000676-18 03/28/2018 4:41:16 PM Pg 1 of 2 Trans ID: SCP 2018682199 Marlena S. Diaz-Cobo, Esquire 03902201 0 McGovern Legal Services, LLC 850 Carolier Lane North Brunswick, NJ 08902 (732) 246-1221 Attorneys for Plaintiff THE RITZ CONDOMINIUM ASSOCIATION, SUPERIOR COURT OF NEW JERSEY INC., LAW DIVISION-SPECIAL CIVIL PART …
Jan 31, 2018
Closed
Atlantic County, NJ
Mar 28, 2018
BUR-L-002428-18 02/06/2019 1:33:12 PM Pg 1 of6 Trans ID: LCV2019230536 GURBIR S. GREWAL ATTORNEY GENERAL OF NEW JERSEY Richard J. Hughes Justice Complex 25 Market Street P.O. Box 114 Trenton, New Jersey 08625-0114 Attorney for Plaintiff, State of New Jersey, by the Commissioner of Transportation By: Matthew R. Weiss Attorney I.D. # 216682017 Deputy Attorney General (609) 376-3300 …
BUR-L-002428-18 02/06/2019 1:33:12 PM Pg 1 of6 Trans ID: LCV2019230536 GURBIR S. GREWAL ATTORNEY GENERAL OF NEW JERSEY Richard J. Hughes Justice Complex 25 Market Street P.O. Box 114 Trenton, New Jersey 08625-0114 Attorney for Plaintiff, State of New Jersey, by the Commissioner of Transportation By: Matthew R. Weiss Attorney I.D. # 216682017 Deputy Attorney General (609) 376-3300 …
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