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Home
About
Executive Committee
Committees
ACT-SO
Community Coordination
Economic Empowerment
Education
Health
Criminal Justice
Membership Committee
Religious Affairs
Political Action
>
2022VoterGuide
Legal Redress
Veterans Affairs
Youth and College Division
Become A Member
Contact Us
File A Complaint
Events
Spring Fling 2019
flapjack2019
Freedom Fund
Freedom Fund 2018
Freedom Fund 2019
Freedom Fund 2021
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File A Complaint Form
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Name
*
First
Last
Phone Number
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Email
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Address
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Line 1
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City
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Nature of Complaint
*
Business Opportunity
Credit
Education
Employment
Housing
Other
Explanation of Complaint
*
Do You Believe You Were Discriminated Against Because of?
*
Race
Sex
Religion
National Origin
Color
Age
Disability
Other
Are You Aware of Other Individuals Who May Have Been Subjected To The Alleged Discriminatory Conduct? If Yes, Provide Names, Addresses, And Telephone Numbers, If Possible
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What Remedy Are You Seeking?
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Have You Sought Or Received Assistance From The Equal Employment Opportunity Commission Or Any Other Agency? If Yes Provide Names, Addresses, And Telephone Numbers, If Possible
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Are You Represented By A Private Attorney? If Yes, Provide Name, Address, And Telephone Number
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Is A Court Action Pending? If Yes, Provide Case File Number And A Copy Of The Complaint
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NOTE:
This complaint form is NOT the equivalent of filing a formal charge with the Equal Employment Opportunity Commission (EEOC).
In filing this complaint, I understand that the NAACP is not my private attorney, but assists the public with information/investigation/conciliation/attorney referral with respect to laws designed to protect the public from patterns and practices of discrimination or discriminatory policies. I also understand that this complaint form is not a lawsuit, but rather an informal preliminary summation to obtain guidance on my belief that I have been discriminated against. I understand that the NAACP may use its discretion to determine whether an investigation is warranted and may need to contact the person/entity I am complaining about. This serves as authority to make such contact and obtain any information, personal or confidential. I retain the right to contact a private attorney. NAACP may refer me to a private attorney and may communicate with the attorney on my behalf. The above complaint is true and accurate to the best of my knowledge. I also understand that any false statement made in this complaint is grounds for the NAACP to refuse further assistance and may make disclosure to proper authorities.
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