© Copy right by EEO 21, LLC
275 East Street Road, #27, Feasterville, PA, U.S.A.
EEOC Charge form (5) (for private
employment discrimination complaint filing
at EEOC; not for
federal employees)

Designation of Representative and EEO
Counselor Contact form -- for establishing
contact with EEO Counselor to file
discrimination complaint in federal
employment and for notifying your

Designation of Representative for EEO
Formal Complaint Process

Designation of Representative for EEOC
hearing process

Complainant Affidavit      (See also How to
Write a Complaint of Discrimination)

Complainant Affidavit (for USPS)

Witness Affidavit

Witness Questionnaire

Certificate of Service

Verification or Declaration

Medical Questionnaire on Disabilities (a
sample to be sent to your doctor to verify your

Motion to EEOC Judge (blank form)
Disclaimer: Forms herein are provided by courtesy of EEO 21, LLC for public use.  Some may need to be updated or
may not be accepted in relevant proceedings.  Use them at your own peril.  
Forced Resignation or Constructive
Discharge sample letter

Discrimination Complaint to US District Court
sample (non-hire or denied promotion)

Discrimination Complaint to US District Court
Pro se (non-hire or denied promotion) (PDF)

Actual US District Court Complaint re ADAAA
(Word Doc)

Forms for EEOC hearing

Forms for OFO appeal
General Discrimination Complaint Forms
President Obama's Executive Order on FOIA
dated January 21, 2009.

USDA Secretary Vilsack Memo dated April 21,
2009: "
A New Civil Rights Era for USDA."
Federal EEO process explained.

EEO Counselor's Checklist: Notice of
Pre-/Complainant Rights and
Responsibilities.  This worksheet of checklist
lays out Complainant's rights and
responsibilities throughout the federal EEO
process for GSA but applicable to all other
federal agencies.  A good overview.
    EEOC hearings
    EEO representation
    MSPB appeal hearings
    Federal employment discrimination specialist
    serving nationwide
    from Philadelphia