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Click ‘Get Form’ to open it in the editor.
Begin by entering your name in the designated fields: first, middle initial, and last. Ensure accuracy as this information is crucial for identification.
Fill in your address, including city, state, and ZIP code. This helps establish your location for the EEOC's records.
In the section regarding discriminatory actions, briefly describe what happened and any harm caused. If more space is needed, utilize additional pages.
Indicate the basis of discrimination by checking the appropriate boxes related to race, sex, age, etc., and provide any necessary explanations.
Complete the sections about your employer or union involvement and provide their names and addresses as required.
Finally, review all entries for accuracy before signing and dating the form at the bottom.
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