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This version of the form is not currently in use and is provided for reference only. Download this version of
DSHS Form 22-552
for the current year.
DSHS Form 22-552 Discrimination Complaint - Nondiscrimination in the Basic Food Program - Washington (Cambodian)
This is a legal form that was released by the Washington State Department of Social and Health Services - a government authority operating within Washington.
The document is provided in Cambodian. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is DSHS Form 22-552?
A: DSHS Form 22-552 is a Discrimination Complaint form related to nondiscrimination in the Basic Food Program in Washington.
Q: What is the Basic Food Program?
A: The Basic Food Program is a food assistance program in Washington that helps low-income individuals and families buy food.
Q: Who can file a discrimination complaint using the DSHS Form 22-552?
A: Anyone who believes they have been discriminated against in the Basic Food Program in Washington can file a discrimination complaint using this form.
Q: What is the purpose of the form?
A: The purpose of the form is to allow individuals to report discrimination they have experienced in the Basic Food Program.
Q: What should be included in the complaint?
A: The complaint should include details about the discriminatory actions, the date and location of the incident, and the names of any individuals involved.
Q: How can I submit the completed form?
A: The completed form can be submitted to the Washington State Department of Social and Health Services (DSHS) either by mail, fax, or in person.
Form Details:
- Released on June 1, 2022;
- The latest edition provided by the Washington State Department of Social and Health Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
Download a printable version of DSHS Form 22-552 by clicking the link below or browse more documents and templates provided by the Washington State Department of Social and Health Services.
Download DSHS Form 22-552 Discrimination Complaint - Nondiscrimination in the Basic Food Program - Washington (Cambodian)
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