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Human Relations Commission

Complaint of Discrimination

NOTICE: Under the California Public Records Act and other disclosure statues, 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) whom 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?
Other Individuals
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)?
The City of San Diego Human Relations Commission will try to mediate your complaint if the other party agrees to the mediation. What do you want to happen as a result of the mediation?
Explain in detail how you feel you were discriminated against. (Include the all dates relevant to the alleged discrimination that took place.) You should attach any copies of documents that you believe will support your charge.

One file only.
2 MB limit.
Allowed types: txt, pdf, doc, docx.
Affirmation