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Complaint No. (DLR Use Only) COMPLAINT OF DISCRIMINATION FORM *Only for complaints of alleged discrimination against an employee, program or policy of the Department of Labor, Licensing and Regulation
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How to fill out complaint of discrimination form

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How to fill out a complaint of discrimination form:

01
Start by carefully reading the instructions provided with the complaint form. Familiarize yourself with the requirements and guidelines for filling out the form.
02
Provide your personal information accurately and completely. This may include your full name, address, phone number, and email address.
03
Clearly state the type of discrimination you believe you have experienced. This could include discrimination based on race, gender, age, disability, or any other protected characteristic.
04
Describe the specific incidents or actions that led to your belief of discrimination. Provide dates, times, locations, and individuals involved, if applicable.
05
Explain how the discrimination has negatively impacted you. Provide details about any emotional distress, loss of job opportunities, or other harm you have suffered.
06
Identify any witnesses who can support your claim. Include their contact information and any statements they can provide.
07
If you have any supporting documents, such as emails, memos, or photographs, attach copies to the complaint form. Make sure to indicate the relevance of each document.
08
If you have already taken any steps to address the discrimination internally or with an external agency, mention them in your complaint.
09
Sign and date the complaint form, certifying that the information you provided is true and accurate to the best of your knowledge.
10
Keep a copy of the completed complaint form for your records.

Who needs a complaint of discrimination form?

01
Individuals who believe they have experienced discrimination in any area of their life, such as employment, housing, education, or public accommodations, may need a complaint of discrimination form.
02
Employees who have encountered discrimination in the workplace and wish to file a complaint with their employer or a government agency may need a complaint form.
03
Students who have faced discrimination in an educational institution and want to report the incident may require a complaint of discrimination form.
04
Individuals who have been denied housing or faced discrimination by a landlord or housing provider might need a complaint form to initiate an investigation.
05
Any person who believes they have been subjected to discrimination based on their race, color, religion, sex, national origin, age, disability, or other protected class status can utilize a complaint of discrimination form to voice their concerns and seek resolution.
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The complaint of discrimination form is a document used to report allegations of discrimination based on race, gender, age, disability, or other protected characteristics.
Anyone who believes they have been discriminated against in a specific situation is required to file a complaint of discrimination form.
To fill out a complaint of discrimination form, one must provide detailed information about the alleged discriminatory incident, including dates, locations, witnesses, and evidence.
The purpose of a complaint of discrimination form is to document and address allegations of discrimination in a formal and organized manner.
The complaint of discrimination form typically requires information about the complainant, the alleged discriminator, the nature of the discrimination, and any supporting evidence.
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