Caption
Complainant and respondent identification, addresses, and contact details for official service and correspondence.
A clear, timely Complaint of Discrimination preserves legal rights, sets the factual record for investigators, and triggers statutory deadlines and procedural safeguards under state and federal law.
Use this form if you are an individual alleging discrimination, or if you represent a claimant or employer responding to a charge.
Accurate completion helps investigators assess jurisdiction and next steps, and reduces the chance of administrative dismissal or delay.
The person alleging discrimination. Provide full legal name, contact information, employer details, and a clear narrative of alleged acts with dates to establish a prima facie record for intake and investigation.
The New Jersey Division on Civil Rights or EEOC investigator assigned to the charge. They manage intake, mediation offers, evidence collection, and notices such as right-to-sue letters and investigation outcomes.
Complainant and respondent identification, addresses, and contact details for official service and correspondence.
Concise chronological narrative describing each relevant incident, with dates, locations, and the persons involved.
Explicit list of alleged bases for discrimination such as race, sex, age, religion, disability, or national origin.
Specific remedies sought, such as back pay, reinstatement, policy change, or injunctive relief.
Exhibits numbered and described, including emails, performance reviews, medical notes, or witness statements.
Signature and date statement affirming the truthfulness of the complaint under penalty of law.
Offer letters, performance reviews, disciplinary notices, payroll records, and termination letters to establish status and damages.
Emails, texts, and internal messages showing complaints, instructions, or discriminatory remarks and the timeline of events.
Doctor notes, accommodation requests, and HR correspondence supporting disability-related claims and timelines.
Signed or dated summaries from colleagues who observed incidents, including contact details for follow-up.
| Field | Configuration |
|---|---|
| Required Fields | Full name, contact, incident date, protected basis |
| Attachment Limits | Allow PDFs, JPGs; set 25 MB per file |
| Reviewer Routing | Route to intake investigator then to assigned investigator |
| Audit Trail | Enable timestamped logs for all submissions |
Electronic filing and signatures are accepted for many administrative complaints if they meet legal validity tests and agency requirements.
Ensure the chosen platform supports ESIGN/UETA compliance, preserves a tamper-evident audit trail, and offers secure storage consistent with privacy obligations.
180 days (300 days in state-covered circumstances)
DCR or state agency deadlines may differ; verify locally
Issued when administrative remedies are exhausted
Keep records as soon as possible to support claims
Civil suits follow receipt of a right-to-sue letter
Optica consolidated intake forms into an online workflow to reduce follow-up.
Property managers used digital signing to replace manual complaint routing and storage.
| signNow | DocuSign | Adobe Sign | PandaDoc | HelloSign | |
|---|---|---|---|---|---|
| Starting Price | $8/user/mo | $15/user/mo | $14/user/mo | $19/user/mo | $15/user/mo |
| Free Trial | 7-day free trial | Varies by vendor | Varies by vendor | Varies by vendor | Varies by vendor |
| Bulk Send | Yes | Yes | Yes | Yes | No |
| Audit Trail | Yes | Yes | Yes | Yes | Yes |
| HIPAA Compliant | Yes | Yes | Yes | No | No |