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Jurisdictional Elements:
For further information visit: http://phoenix.gov/EOD/discempl.html
Please identify potential witnesses by name, title and department. Include address and phone number where known:
What happened to you? Please include dates, witnesses and/or comparative employees who were treated differently. How were you discriminated against? For example: Were you terminated, not selected for a position, demoted or treated differently in the terms and conditions of your employment?*
Why do you believe you are being discriminated against? It is a violation of the law to discriminate against, or harass in any aspect of employment for the following reasons: race, sexual orientation, color, religion, gender, national origin, or marital status. Briefly explain why you think your employment rights were denied because of any of the factors listed above.* Who do you believe discriminated against you? Was it your supervisor, a co-worker or subordinate?
Name:
If applicable, what is that persons: Is the alleged discrimination ongoing? Yes No When did the last act of discrimination occur? Enter the date (mm/dd/yyyy)* * Required fields Use the submit button below to e-mail your completed form to the intake officer: eod.complaint.enforcement@phoenix.gov If you prefer, you may call, mail or fax the completed questionnaire to the Equal Opportunity Department at:
City of Phoenix Equal Opportunity Department The Equal Opportunity Department will make every attempt to contact you within 48 hours of receipt of your complaint. Contact information for employers outside of Phoenix or who have more than 14 employees:
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