Salt Lake City

Human Resources

Phone: (801) 535-7900

EEO Complaint Form

 


 

 



Please tell us about yourself:

 

And the information of the person you are complaining about:

Complaint Last Name:
Complaint First Name:
Complaint Position:
 

Please check all the reasons you feel you were discriminated against:












 
Please explain the incident or conduct that is the basis of this complaint and include where and when it took place.
Why do you believe these actions were discriminatory and/or harassing?
What reasons, if any, were given to you for the acts you consider to be discriminatory and/or harassing?
Describe the corrective action you are seeking
Suggested witnesses and contact information if known (e-mail and telephone numbers if you have them):
What do you believe these witnesses will tell us?
Have you discussed this complaint with anyone else? Yes or no (if yes, list their name and contact information).