General Complaint Against School District

COMPLAINT UNDER THE FAMILY EDUCATIONAL RIGHTS AND PRIVACY ACT (FERPA) (Date) TO: Family Policy Compliance Office U.S. Department of Education 400 Maryland Avenue. S.W. Washington, D.C. 20202-4605 RE: School In Violation Of FERPA I hereby lodge an official complaint against the School District of _____________ on behalf of (student's name) who attends (name of school) for what I believe to be: [ ] Inappropriate maintenance of records/content [ ] A violation of the Family Educational Rights and Privacy Act of 1974. The nature of the complaint is as checked: [ ] Challenge to Record or Content ____ Inaccurate ____ Misleading ____ Incomplete ____ Inappropriate Record challenged may be identified as: Title:____________________________ Date:_____________________________ Person responsible for Entry or person currently maintaining record:___________________________ Date challenged content discovered:___________ [ ] Alleged Violations of Act or Regulations ____ Failure to provide notification of all rights (totally or in needed language) ____ Failure to publish local access and hearing procedures ____ Inappropriate person(s) grant denied access ____ Failure to provide interpretation assistance as requested ____ Failure to provide requested hearing ____ Failure to provide uninvolved hearing officer ____ Failure of hearing officer to provide written opinion within reasonable time ____ Inappropriate sharing of confidential information ____ Other: _______________________________________________ Date of Violation:___________________ Date Violation Discovered if different from above:________________ Other Relevant Information: (Use this section to add any additional explanatory comments) ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ ___________________________________________________________ Yours Truly, (Parent Name) (Parent Signature) (Address) (Phone number)

Print it out, fill it out, then mail it (certified, of course with Return Receipt Requested) to the following address:

Family Policy Compliance Office
U.S. Department of Education
400 Maryland Avenue. S.W.
Washington, D.C. 20202-4605