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Click ‘Get Form’ to open it in the editor.
Begin with Part I, where you will provide your personal information. Fill in your name, address, and contact details accurately. Ensure that your home address is current, as any changes must be reported.
In section 6, indicate your employment status related to the complaint. Select from options such as 'Current Employee' or 'Former Employee' and provide relevant details like title and grade.
Proceed to Part II to designate a representative if desired. You can choose someone to represent you throughout the process. Fill in their contact information and confirm if they are an attorney.
In Part III, describe the alleged discriminatory actions clearly. Provide specific details about what occurred, including dates and names of individuals involved.
Finally, review all sections for accuracy before signing and dating the form at the end. Ensure that all required fields are completed.

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