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Title VII Complaint - Colorado
| Title VII Complaint Form. This is a Colorado form and can be used in Civil District Court Federal . |
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IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLORADO Civil Action No. (To be supplied by the court) , Plaintiff, v. , Defendant. TITLE VII COMPLAINT PARTIES 1. Plaintiff is a citizen of who presently resides at the following address: 2. Defendant lives at or is located at the following address: Attach a separate page, if necessary, to list additional parties. JURISDIC TION 3. Jurisdiction is asserted pursuant to Title VII of the Civil Rights Act of 1964, 42 U.S.C. 2000e-5. 4. Defendant is an employer within the meaning of Title VII. 5. The alleged unlawful employment practices took place at the following location: 6. Jurisdiction also is asserted pursuant to the following statutory authority:(Rev. 04/15/02) <<<<<<<<<********>>>>>>>>>>>>> 2 ADMINISTR ATIVE PR OCEDURES 7. Plaintiff filed a charge of discrimination with the Equal Employment Opportunity Commission or other appropriate administrative agency on (date) regarding the alleged discriminatory conduct by Defendant(s). 8. Plaintiff received from the Equal Employment Opportunity Commission or other appropriate administrative agency a Notice of Right to Sue the Defendant(s) on ________________ (date). (Please attach to the complaint a copy of the Notice of Right to Sue.) NATURE OF THE CASE 9. Defendant has discriminated against Plaintiff because of the following: (please check all that apply) Race Color Religion Sex National Origin Other (please specify) 10. Defendant has discriminated against Plainti2ff because of the following: (please check all that apply) Failure to hire Failure to promote Demotion/discharge from employment Other (please specify) (Rev. 04/15/02) 2 <<<<<<<<<********>>>>>>>>>>>>> 3 FIRST CLA IM FOR R ELIEF AND SUPPORTING FACTUAL ALLEGATIONS (Please number your paragraphs and attach any necessary additional pages. Alternatively, you may attach to the complaint a copy of the charge of discrimination you submitted to the Equal Employment Opportunity Commission.)(Rev. 04/15/02) 3<<<<<<<<<********>>>>>>>>>>>>> 4 SECOND CLA IM FOR R ELIEF AND SUPPORTING FACTUAL ALLEGATIONS (Please number your paragraphs and attach any necessary additional pages.)(Rev. 04/15/02) 4<<<<<<<<<********>>>>>>>>>>>>> 5 THIRD CLAI M FOR R ELIEF AND SUPPORTING FACTUAL ALLEGATIONS (Please number your paragraphs and attach any necessary additional pages.)(Rev. 04/15/02) 5<<<<<<<<<********>>>>>>>>>>>>> 6 REQUEST FO R RELIEF Plaintiff requests the following relief: Date: (Plaintiffs Original Signature) (Street Address) (City, State, ZIP) (Telephone Number)(Rev. 04/15/02) 6
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