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EEOC Complaint - Alabama
| EEOC Complaint Form. This is a Alabama form and can be used in Middle District District Court Federal . |
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IN THE UNITED STATES DISTRICT COURT FOR THE MIDDLE DISTRICT OF ALABAMA _____________________ DIVISION _____________________________ _____________________________ _____________________________ PLAINTIFF v. _____________________________ _____________________________ _____________________________ DEFENDANT CASE ACTION NO.:______________________ EEOC COMPLAINT 1. Plaintiff resides at _____________________________________________________ 2. Defendant(s)' name(s)__________________________________________________ __________________________________________________________________________ Location of principal office(s) of the named defendant(s)_______________________ __________________________________________________________________________ __________________________________________________________________________ Nature of defendant(s)' business__________________________________________ __________________________________________________________________________ Approximate number of individuals employed by defendant(s)__________________ 3. This action is brought pursuant to Title VII of the Civil Rights Act of 1964 for employement discrimination. Jurisdiction is specifically conferred on the Court by 42 U.S.C. §2000e-5. Equitable and other relief are also sought under 42 §2000e-5(g). The acts complained of in this suit concern: 4. 1. __ Failure to employ me. 2. __ Termination of my employment. 3. __ Failure to promote me. 4. __ Other acts as specified below:____________________________________ __________________________________________________________________________ __________________________________________________________________________ 1 American LegalNet, Inc. www.FormsWorkflow.com 5. Plaintiff is: A. ___ Presently employed by the defendant. ___ Not presently employed by the defendant. The dates of employement were ________________________________ Employment was terminated because: (1) (2) (3) _____ Plaintiff was discharged. _____ Plaintiff was laid off. _____ Plaintiff left job voluntarily. 6. Defendant(s)' conduct is discriminatory with respect to the following: A. ____ My race. B. ____ My religion. C. ____ My sex. D. ____ My national origin. E. ____ Other, as specified below:_____________________________________ __________________________________________________________________________ __________________________________________________________________________ 7. The name(s), race, sex, and the position or title of the individual(s) who allegedly discriminated against me during the period of my employment with the defendant company is (are)_______________________________________________________ __________________________________________________________________________ __________________________________________________________________________ 8. 9. The alleged discrimination occurred on or about_____________________________. The nature of my complaint, i.e., the manner in which the individual(s) named above discriminated against me in terms of the conditions of my employment, is as follows: __________________________________________________________________________ ___________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ _____________________________________________________________________________ ___________________________________________________________________________ ____________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ 10. The alleged illegal activity took place at ____________________________________ __________________________________________________________________________ __________________________________________________________________________ __________________________________________________________________________ 2 American LegalNet, Inc. www.FormsWorkflow.com 11. I filed charges with the Equal Employment Opportunity Commission regarding defendant(s)' alleged discriminatory conduct on or about ______________________. I have attached a copy of the Notice-of-Right-to-Sue letter issued by the Equal Employment Opportunity Commission. The letter was received by me on ____________. I seek the following relief: A. B. ___ Recovery of back pay. ___ Reinstatement to my former job, and any other relief as may be appropriate, including injunctive orders, damages, costs, and attorneys fees. __________________________________ Signature of Plaintiff __________________________________ __________________________________ __________________________________ Address & Telephone Number of Plaintiff 12. Date:____________________________ 3 American LegalNet, Inc. www.FormsWorkflow.com
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