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Civil rights complaint form

This form is to be used by individuals who wish to file a civil rights complaint.

2 minutes to complete

Eligibility

If you believe that you have been discriminated against, you may file a civil rights complaint form.

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Questions for Civil rights complaint form

Questions

1.

What is your name?

The answer should be a text input.
2.

What is your age?

The answer should be a number input.
3.

What is your address?

The answer should be a text input.
4.

What is your phone number?

The answer should be a phone number.
5.

What is your email address?

The answer should be an email input.
6.

What is the nature of your complaint?

The answer should be a text input.
7.

When did the alleged incident(s) occur?

The answer should be a text input.
8.

Where did the alleged incident(s) occur?

The answer should be a text input.
9.

Who was involved in the alleged incident(s)?

The answer should be a text input.
10.

What evidence do you have to support your complaint?

The answer should be a text input.

Forms Similar to Civil rights complaint form

  • Equal Employment Opportunity Commission Complaint Form
  • Department of Justice Civil Rights Complaint Form
  • U.S. Commission on Civil Rights Complaint Form

Here are some FAQs and additional information
on
Civil rights complaint form

What is a civil rights complaint form?

A civil rights complaint form is a document filed with a government agency or department that alleges that an individual has been the victim of discrimination based on their race, religion, sex, national origin, or disability. The form typically requests that an investigation be conducted to determine if the allegations are true and, if so, what action should be taken to remedy the situation.

What information is required on a civil rights complaint form?

The information required on a civil rights complaint form will vary depending on the agency or department that is responsible for investigating the allegations. However, most forms will require the complainant to provide their contact information, as well as details about the alleged discrimination, such as when and where it occurred.

What are the consequences of filing a false civil rights complaint?

Filing a false civil rights complaint is a serious matter and can result in criminal charges being filed against the individual who made the false allegations.

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