Before I file with the Civil Rights Department
A printable from File a Discrimination Complaint. Fill it in by hand. Nothing you write is collected by this website.
Before I file with the Civil Rights Department
- I know the date of the last thing that happened: __________ (deadline: generally 3 years later)
- My phone, email or mailing address
- Employer's business name and address
- Names of the people involved and their jobs
- The trait I believe it was about: __________
- A timeline of what happened, with dates
- What it cost me (job, hours, pay, promotion)
- Witness names and how to reach them
- Copies of texts, emails, schedules, pay stubs, write ups
- Any complaint I made at work, and the date
- My language, if I want an interpreter
After I file
- Complaint number: __________
- Interview date and time: __________
- I will tell the department if my contact details change
Do not write your immigration status on this sheet.
From File a Discrimination Complaint. Facts checked October 21, 2026. Free information, not legal or medical advice.