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PDFWAC 132U-300-140

Other discrimination complaint options.

Discrimination complaints may also be filed with the following federal and state agencies:
Washington State Human Rights Commission at
U.S. Dept. of Education Office for Civil Rights at
Equal Employment Opportunity Commission at
Complaint Form
This form is designed to assist you with filing a discrimination and/or harassment complaint. Please write clearly and focus on the alleged discriminatory and/or harassing conduct. The complaint should include as much information regarding the incident giving rise to the complaint as possible, including the location, date and time of the alleged incident(s); the name of the individual or group whom the complaint is against, if known; a description of the incident(s); and the remedy sought.
Name of person filing the complaint: _____
Date: _____
Signature: _____
Date: _____
You may use the back side of this sheet if needed. Please return this form to the Title IX/EEO coordinator, LDC 235.
[Statutory Authority: Chapter 28B.50 RCW. WSR 18-17-025, § 132U-300-140, filed 8/6/18, effective 9/6/18.]
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