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Human Relations Commission

Complaint of Discrimination

NOTICE: Under the California Public Records Act and other disclosure statutes, the information contained in this complaint form cannot be kept confidential.

*Indicates a required field

Your Information
Are you currently employed?
What is your gender?
Are translation services required?
Name the person(s) and/or organization(s) who you feel discriminated against you
Discrimination Details
I was discriminated against in:
I believe I was discriminated against because of my (check all that apply):
Have you filed this complaint with any other agency?
Have you ever filed a complaint with this office before?
Do you know other individuals who feel they were discriminated against or who witnessed the alleged discriminations by the above person(s) and/or organization(s)?

One file only.
2 MB limit.
Allowed types: txt, pdf, doc, docx.
I swear or affirm that I have read the above claim and that it is true to the best of my knowledge, information and belief. I understand that the respondent will be notified of the claim.