Complaint For Employment Discrimination

About These Forms 1. In General. This and the other pleading forms available from the www.uscourts.gov website illustrate some types of information that are useful to have in complaints and some other pleadings. The forms do not try to cover every type of case. They are limited to types of cases often filed in federal courts by those who represent themselves or who may not have much experience in federal courts. 2. Not Legal Advice. No form provides legal advice. No form substitutes for having or consulting a lawyer. If you are not a lawyer and are suing or have been sued, it is best to have or consult a lawyer if possible. 3. No Guarantee. Following a form does not guarantee that any pleading is legally or factually correct or sufficient. 4. Variations Possible. A form may call for more or less information than a particular court requires. The fact that a form asks for certain information does not mean that every court or a particular court requires it. And if the form does not ask for certain information, a particular court might still require it. Consult the rules and caselaw that govern in the court where you are filing the pleading. 5. Examples Only. The forms do not try to address or cover all the different types of claims or defenses, or how specific facts might affect a particular claim or defense. Some of the forms, such as the form for a generic complaint, apply to different types of cases. Others apply only to specific types of cases. Be careful to use the form that fits your case and the type of pleading you want to file. Be careful to change the information the form asks for to fit the facts and circumstances of your case. 6. No Guidance on Timing or Parties. The forms do not give any guidance on when certain kinds of pleadings or claims or defenses have to be raised, or who has to be sued. Some pleadings, claims, or defenses have to be raised at a certain point in the case or within a certain period of time. And there are limits on who can be named as a party in a case and when they have to be added. Lawyers and people representing themselves must know the Federal Rules of Civil Procedure and the caselaw setting out these and other requirements. The current Federal Rules of Civil Procedure are available, for free, at www.uscourts.gov. 7. Privacy Requirements. Federal Rule of Civil Procedure 5.2 addresses the privacy and security concerns over public access to electronic court files. Under this rule, papers filed -security number or full birth date; the name of a person known to be a minor; or a complete financial-account number. A filing may include only the last four digits of a social-security number and taxpayer identification numberdigits of a financial-account number. American LegalNet, Inc. www.FormsWorkFlow.com en-CAIN THE UNITED STATES DISTRICT COURT en-CAFOR THE DISTRICT OF en-CA DIVISION (Write the District and Division, if any, of the court in which the complaint is filed.) (Write the full name of e ach plaintiff who is filing this complaint. If the names of all the plaintiffs cannot fit in the space above page with the full list of names.) - against - (Write the full name of e ach defendant who is being sued. If the names of all the defendants cannot fit in the sp ace above n the space and attach an addi tional page with the full list of names.) Complaint for Employment Discrimination Case No. (t o be ) Jury Trial: Yes No (check one) American LegalNet, Inc. www.FormsWorkFlow.com 2 I. The Parties to This Complaint A. The Plaintiff(s) Provide the information below for each plaintiff named in the complaint. Attach additional pages if needed. Name Street Address City and County State and Zip Code Telephone Number E-mail Address B. The Defendant(s) Provide the information below for each defendant named in the complaint, whether the defendant is an individual, a government agency, an organization, or known). Attach additional pages if needed. Defendant No. 1 Name Job or Title (if known) Street Address City and County State and Zip Code Telephone Number E-mail Address (if known) Defendant No. 2 Name Job or Title (if known) Street Address City and County American LegalNet, Inc. www.FormsWorkFlow.com 3 State and Zip Code Telephone Number E-mail Address (if known) Defendant No. 3 Name Job or Title (if known) Street Address City and County State and Zip Code Telephone Number E-mail Address (if known) Defendant No. 4 Name Job or Title (if known) Street Address City and County State and Zip Code Telephone Number E-mail Address (if known) C. Place of Employment The address at which I sought employment or was employed by the defendant(s) is: Name Street Address City and County State and Zip Code Telephone Number American LegalNet, Inc. www.FormsWorkFlow.com 4 II. Basis for Jurisdiction This action is brought for discrimination in employment pursuant to (check all that apply): Title VII of the Civil Rights Act of 1964, as codified, 42 U.S.C. 247247 2000e to 2000e-17 (race, color, gender, religion, national origin). (Note: In order to bring suit in federal district court under Title VII, you must first obtain a Notice of Right to Sue letter from the Equal Employment Opportunity Commission.) Age Discrimination in Employment Act of 1967, as codified, 29 U.S.C. 247247 621 to 634. (Note: In order to bring suit in federal district court under the Age Discrimination in Employment Act, you must first file a charge with the Equal Employment Opportunity Commission.) Americans with Disabilities Act of 1990, as codified, 42 U.S.C. 247247 12112 to 12117. (Note: In order to bring suit in federal district court under the Americans with Disabilities Act, you must first obtain a Notice of Right to Sue letter from the Equal Employment Opportunity Commission.) Other federal law (specify the federal law): Relevant state law (specify, if known): Relevant city or county law (specify, if known): III. Statement of Claim Write a short and plain statement of the claim. Do not make legal arguments. State as briefly as possible the facts showing that each plaintiff is entitled to the damages or other relief sought. State how each defendant was involved and what each defendant did that caused the plaintiff harm or violated the plaiof that involvement or conduct. If more than one claim is asserted, number each claim and write a short and plain statement of each claim in a separate paragraph. Attach additional pages if needed. American LegalNet, Inc. www.FormsWorkFlow.com 5 A. The discriminatory conduct of which I complain in this action includes (check all that apply): Failure to hire me. Termination of my employment. Failure to promote me. Failure to accommodate my disability. Unequal terms and conditions of my employment. Retaliation. Other acts (specify): (Note: Only those grounds raised in the charge filed with the Equal Employment Opportunity Commission can be considered by the federal district court under the federal employment discrimination statutes.) B. It is my best recollection that the alleged discriminatory acts occurred on date(s) C. I believe that defendant(s) (check one): is/are still committing these acts against me. is/are not still committing these acts against me. D. Defendant(s) discriminated against me based on my (check all that apply and explain): race color gender/sex religion national origin age. My year of birth is . (Give your year of birth only if you are asserting a claim of age discrimination.) disability or perceived disability (specify disability) E. The facts of my case are as follows. Attach additional pages if needed. American LegalNet, Inc. www.FormsWorkFlow.com 6 (Note: As additional support for the facts of your claim, you may attach to this complaint a copy of your charge filed with the Equal Employment Opportunity Commission, or the charge filed with the relevant state or city human rights division.) IV. Exhaustion of Federal Administrative Remedies A. It is my best recollection that I filed a charge with the Equal Employment Opportunity Commission or my Equal Employment Opportunity counselor regarding the de (date) B. The Equal Employment Opportunity Commission (check one): has not issued a Notice of Right to Sue l