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Fillable CHARGE OF DISCRIMINATION - SCOTUSblog

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II II CHARGE OF DISCRIMINATION This form is affected by the Privacy Act of 1974; See Privacy act statement before completing this form. AGENCY CHARGE NUMBER ___ and EEOC State or local Agency, if any NAME (Indicate Mr.. Ms., Mrs.) STREET ADDRESS CITY. STATE AND ZIP CODE [ ] FEPA [x] EEOC HOME TELEPHONE (Include Area Code) DATE OF BIRTH NAMED IS THE EMPLOYER, LABOR ORGANIZATION, EMPLOYMENT AGENCY,...
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