Fair Employment and Housing Act Form

FAIR EMPLOYMENT AND HOUSING ACT FORM

This Fair Employment and Housing Act Complaint and Resolution Agreement is made and entered into on Date: by and between Complainant Name: whose address is and Respondent Name (Employer): with principal place of business at .

RECITALS

WHEREAS, Complainant asserts that Respondent engaged in employment practices in violation of the Fair Employment and Housing Act by reason of alleged discrimination, harassment, retaliation or failure to provide reasonable accommodation occurring on or about ; and

WHEREAS, the parties desire to set forth their agreement regarding investigation, remedial measures, and any resolution, without admission of liability by Respondent, and to memorialize obligations and rights arising under applicable law;

WHEREAS, the parties intend that this instrument constitute a complete, binding agreement resolving the matters addressed herein, subject to the terms and conditions set forth below.

NOW, THEREFORE, in consideration of the mutual covenants and promises contained herein, the parties agree as follows:

1. DEFINITIONS

For the purposes of this Agreement, the following definitions apply: "Claim" means any alleged violation of rights under the Fair Employment and Housing Act arising from the facts described in the Recitals. "Effective Date" means the date set forth in the opening paragraph. "Confidential Information" means information designated under Section 5 below.

2. ALLEGATIONS AND CLAIMS

Complainant alleges the following categories of impermissible conduct (check all that apply):

Discrimination Harassment Retaliation Failure to Accommodate

Short description of alleged facts and specific acts giving rise to the claim:

3. INVESTIGATION, INTERACTIVE PROCESS, AND REMEDIES

Respondent agrees to undertake a timely, objective investigation of the allegations and, where appropriate, to engage in the interactive process to determine reasonable accommodation. Respondent shall complete its internal investigation by , unless extended by mutual written agreement.

If a resolution requires remedial action, Respondent shall implement measures which may include but are not limited to training, reassignment of duties, reasonable accommodation, discipline, or monetary remediation as appropriate under governing law. Any agreed monetary settlement shall be disbursed as follows:

Settlement Amount (if applicable):

Allocation of settlement funds and tax treatment shall be documented in a separate settlement schedule attached as an addendum to this Agreement, and shall be consistent with applicable statutory and regulatory requirements.

4. CONFIDENTIALITY AND NON-ADMISSION

Except as required by law or necessary to effectuate the terms of this Agreement, the parties agree to keep the existence and terms of this Agreement confidential. This Agreement does not constitute an admission of liability by Respondent, and Respondent expressly denies any wrongdoing.

Notwithstanding the foregoing, nothing in this Agreement precludes disclosure to governmental agencies or as otherwise compelled by subpoena, provided the party making such disclosure shall first provide written notice to the other party to the extent permitted by law.

5. NON-DISPARAGEMENT

The parties agree not to make statements, written or oral, that disparage the other party, its agents, employees or representatives with respect to the subject matter of this Agreement, except for truthful statements made in response to legal process or as required by law.

6. COMPLIANCE, COOPERATION AND FUTURE CONDUCT

Each party agrees to cooperate reasonably in implementing remedial measures and to comply with any agreed policies, training, or monitoring. The parties further agree that any breach of material obligations hereunder may give rise to equitable or legal remedies.

7. NOTICES

All notices required or permitted under this Agreement shall be in writing and delivered to the addresses below by personal delivery, certified mail, or overnight courier.

8. GOVERNING LAW; VENUE

This Agreement shall be governed by and construed in accordance with the laws of the State of California and the provisions of the Fair Employment and Housing Act. Exclusive venue for any dispute arising from this Agreement shall lie in a court of competent jurisdiction located in the county in which Respondent's principal place of business is located, unless otherwise required by law.

9. ENTIRE AGREEMENT; SEVERABILITY

This Agreement constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior discussions and agreements, whether written or oral. If any provision of this Agreement is held invalid or unenforceable, the remainder of the Agreement shall continue in full force and effect.

10. AMENDMENT; WAIVER; COUNTERPARTS

Any amendment to this Agreement must be in writing and signed by both parties. No waiver of any provision shall be effective unless in writing and signed by the waiving party. This Agreement may be executed in counterparts, each of which shall be deemed an original, and all of which together shall constitute one instrument.

11. CERTIFICATION AND WARNING

I certify under penalty of perjury under the laws of the State of California that the statements made in this form are true and correct to the best of my knowledge. I acknowledge that intentionally making a materially false statement in this document may subject me to civil or criminal penalties under applicable law.

ADDITIONAL INFORMATION

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