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I affirm that the statements that I have made above are accurate and true to the best of my knowledge and belief. I hereby request the assistance of the Georgia NAACP in seeking a remedy to the situation described above. I hereby authorize the officers of the NAACP Georgia State Conference to have access to information and documents, which are relevant to my claim of discrimination described above. I understand that once a referral to a volunteer, community agency, or private attorney has been made, the NAACP Georgia State Conference  for handling this matter. In fact,  I further understand that by submitting this document, I am agreeing to HOLD the NAACPGeorgia State Conference harmless for any and all damages arising as a result of my case being mishandled, negligently handled, or improperly handled in any way.



Section 704 (a) of the Civil Rights Act of 1964, (as amended), Section 4 (d) of the Age Discrimination in Employment Act of 1967, (as amended), and various other civil rights laws make it an unlawful employment practice for an employer; employment agency; or labor organization: to discriminate against employees, applicants for employment, member or applicant for membership, because the employee, member or applicant has opposed an unlawful employment practice, made a charge, testified, assisted, or participated in any manner in an investigation, proceeding or hearing.



Completing this form does not constitute filing an official complaint with a legal authority. At this time the State Of Georgia NAACP is only seeking information to assist you concerning this complaint. Please send this information and copies of sustaining documents in an envelope marked confidential to:  State of Georgia NAACP  2001 Martin Luther King Jr. Drive, Suite 307,  Atlanta, Georgia 30310


Atlanta Volunteer Lawyers Foundation

Function: This is a nonprofit organization providing legal assistance to low-income residents of Atlanta.

235 Peachtree Street, NE, Suite 1750

Atlanta GA 30303

Web Site:

Atlanta Bar Association

Function:  Lawyer referral service providing information to callers seeking attorneys with expertise in a specific area of practice.

Phone:  (404) 521-0777


American Disabilities Act (ADA)

Function: created to increase awareness of the rights of persons with disabilities, both by persons with disabilities themselves and by the larger community.


1-800-514-0383 (TTY)


American Civil Liberties Union (ACLU)

Function:  The ACLU engages in litigation on civil rights issues including voting rights, criminal justice, prisoner rights, and death penalty cases.

Phone:  (770) 303-8111

FAX:  (770) 303-0060


American & Georgia Bar Certified Lawyer Referral Service

Phone:  1 (800) 215-1644


American & Georgia Bar Certified Lawyer Referral Service

Phone:  1 (800) 215-1644


Atlanta Legal Aid

Function:  Legal representation, advice, and referrals for civil law matters. Also, processes complaints from individuals having difficulty settling claims with an insurance carrier.

54 Ellis Street NE, Atlanta GA 30303

Phone:  (404) 524-5811


Capital Ombudsman Program

Function: Georgia’s Long-Term Care Ombudsman Program works to improve the lives of residents of long-term facilities. The program informally investigates and works to resolve complaints on behalf of residents.

225 Cameron Road, McDonough GA 30253

Phone:  (404) 627-1057

Gate City Bar Association 

Established in 1948, the Gate City Bar Association was organized by the 10 sole African-American lawyers in the city at that time, to provide the educational, social, and community involvement of a professional association for African-American lawyers.

P.O. Box 16727, Atlanta, GA 30321

Phone: (404) 419-6627

Georgia Innocence Project

Function:  The mission is to use DNA testing to free those wrongly prosecuted. Because of the high volume and limited staff, the Project asks that you request help in writing by regular mail, not by phone or email.

50 Hurt Plaza, Suite 350, Atlanta GA 30303

Phone:  (404) 373-4433

Fax:  (404) 609-2704



Georgia Advocacy Office, Inc (GAO)

Function:  The GAO offers pro bono legal services to Georgia residents who have suffered discrimination because of physical and/or mental disabilities.

One Decatur Town Center

150 E. Ponce De Leon Avenue, Suite 430, Decatur, GA 30030

Phone:  (404) 885-1234


Georgia Justice Project Legal Services

Function:  screens potential clients and takes criminal cases only in the beginning stages of prosecution.

438 Edgewood Ave, Atlanta GA 30312

Phone:  (404) 827-0027

Governor’s Office of Consumer Protection

Function:  Enforces Georgia’s Fair Business Practices Act and other consumer protection laws. Investigates and addresses consumer problems. Complaints must be made in writing.


The Innocence Project

Function:  is a non-profit legal clinic affiliated with the Benjamin N. Cardozo School of Law at Yeshiva University and created by Barry C. Scheck and Peter J. Neufeld in 1992. The project is a national litigation and public policy organization dedicated to exonerating wrongfully convicted people through DNA testing and reforming the criminal justice system to prevent future injustice.



Justice Center of Atlanta, Inc (JCA)

Function:  Offers mediation services, usually without charge, in cases including, but not limited to small claims and misdemeanors to various types of civil disputes.

976 Edgewood Avenue, NE, 

Atlanta GA 30307

Phone:  (404) 523-8236


NAACP Legal Defense and Educational Fund, Inc (LDF)

Function: LDF has its roots in the NAACP under the leadership of NAACP legal pioneer Charles Hamilton Houston. In 1940, then NAACP lawyer established the NAACP Legal Defense Fund to support the increasing civil rights litigation across the United States. In 1957 the NAACP Legal Defense Fund became an entirely separate organization from the NAACP, yet LDF remains a partner of the NAACP in the fight for justice. LDF’s primary mission has been to provide legal assistance to poor African Americans; however, its work over the years has brought greater justice to all Americans.

National Headquarters NY 


Washington DC Office


Website: www.naacpldf.

The Southern Center for Human Rights Law Firm

Function:  Offers free legal representation for criminal matters of indigent defense, currently incarcerated prisoners, and death penalty cases.

60 Walton Street, NW, Atlanta GA 30303

Phone:  (404) 688-1202


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