EEOC Form 5 2009-2026 free printable template

EEOC Form 5 (11/09)Agency(IES) Charge No(s):Charge Presented To:CHARGE OF DISCRIMINATIONFEPAThis form is affected by the Privacy Act of 1974. See enclosed Privacy Act Statement and other information

How to fill out eeoc discrimination form

How to fill out EEOC Form 5

1. Begin by obtaining the EEOC Form 5 from the EEOC website or office.
2. Fill out your personal information, including your name, address, and phone number.
3. Provide the name and address of the employer you are filing a charge against.
4. Describe the discriminatory acts that occurred, including dates and specific incidents.
5. Indicate the basis for your charge (e.g., race, color, religion, sex, national origin, age, disability, genetic information).
6. Sign and date the form to certify that the information provided is true and accurate.
7. Submit the completed form to the EEOC by mail or in person.

Who needs EEOC Form 5?

1. Any individual who believes they have been discriminated against in the workplace based on protected characteristics such as race, color, religion, sex, national origin, age, disability, or genetic information.

• Who needs a Charge of discrimination?
• What is the Charge of discrimination for?
• What documents must accompany the Charge of discrimination?
• • Does the Charge of discrimination have a validity period?
  • What information must be provided in the Charge of discrimination?
  • What do I do with the form after its completion?

Who needs a Charge of discrimination?

This form is used by individuals who believe that they are discriminated at their work place due to their race, sex, religion, sexual orientation or other factors. The charge of discrimination is the first step before filing a job discrimination lawsuit.

What is the Charge of discrimination for?

This document contains a very important information which is required by the US Equal Employment Opportunity Commission. This includes the personal information about the complainant and type of discrimination. This form triggers the investigation of the individual’s case.

What documents must accompany the Charge of discrimination?

As a rule, this form is not accompanied by other documents. You may need to provide additional documents after filing this one.

Does the Charge of discrimination have a validity period?

The document must be filed as soon as the discrimination took place and not later than 180 days after the incident.

What information must be provided in the Charge of discrimination?

While completing the form, the complainant has to add the following information:

• Name of the State or Local Agency
• Name, street address, city, phone number, date of birth of the complainant
• Name, street address, number of employees, phone number of the employer, labor organization, employment agency, etc. who discriminated
• Type of discrimination (check the right box: race, retaliation, color, sex, age, religion, disability, national origin, other)
• Date the discrimination took place

The complainant and the charging party also have to sign and date the charge.

The charge of discrimination also must be certified by the notary public.

What do I do with the form after its completion?

The filled out and signed form has to be filed with the US Equal Employment Opportunity Commission.

People Also Ask about eeoc complaint form pdf

What are the EEOC forms of discrimination?

The EEOC is responsible for protecting you from one type of discrimination - employment discrimination because of your race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), national origin, disability, age (age 40 or older), or genetic information.

How successful are EEOC complaints?

When an employer has an EEOC discrimination complaint filed against them, the first reaction is generally anger and fear. Please take a deep breath and know that only 2% of EEOC complaint result in penalties. An EEOC complaint which is an investigation that usually takes at least 10 months to resolve.

How do I win an EEOC complaint against my employer?

How to Win an EEOC Complaint and EEOC Mediation Tips Speak with an Experienced Federal Employment Law Attorney. Successful EEOC complainants usually have an attorney draft their complaint and manage the process. Provide Compelling Evidence. Be Professional and Maintain Composure.

How do I win an EEOC appeal?

Collect evidence. Collect any evidence that you can on the harassment. (Optional) Consult with a lawyer. Contact an EEOC counselor. File a formal complaint. Await an Agency decision. Request a hearing. File an appeal (if your complaint is dismissed) File for reconsideration (if your appeal is dismissed)

What are the 6 EEOC discrimination types?

Under the laws enforced by EEOC, it is illegal to discriminate against someone (applicant or employee) because of that person's race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age (40 or older), disability or genetic information.

Which forms of discrimination are the most common under the EEOC?

The types of discrimination most commonly investigated by the EEOC include: Race, ethnicity, color, or national origin—This type of discrimination denies certain individuals equal access to pay, promotion, benefits, and other work-related perks based primarily on their skin color, culture, or lineage.

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What is EEOC Form 5?

EEOC Form 5 is a form used to collect information about charges of discrimination filed with the Equal Employment Opportunity Commission (EEOC).

Who is required to file EEOC Form 5?

Employers and organizations that receive federal funding, as well as certain other entities that are subject to EEOC jurisdiction, are required to file EEOC Form 5 when they receive a charge of discrimination.

How to fill out EEOC Form 5?

To fill out EEOC Form 5, provide accurate information regarding the charge of discrimination, including the name of the charging party, the employer, the basis of discrimination, and any relevant details regarding the allegations.

What is the purpose of EEOC Form 5?

The purpose of EEOC Form 5 is to document the response to a charge of discrimination, to facilitate the EEOC's investigation, and to ensure compliance with federal laws governing equal employment opportunity.

What information must be reported on EEOC Form 5?

The information that must be reported on EEOC Form 5 includes the names of the parties involved, a description of the alleged discriminatory actions, relevant dates, and any supporting evidence related to the charge.