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Employment and Age Certificate Form 4598 Wage Claim Form 17081 Complaint Inquiry Form 52114 Employment Discrimination Questionnaire/Affidavit Form 14543 Employment Retaliation (Whistleblower) Questionnaire/Affidavit Form 54049 Housing Discrimination Intake Questionnaire Form 52229 Human Rights Discrimination Intake Questionnaire Form 52974 |
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Complaint Inquiry InstructionsForm 52114 (65kb pdf)A Complaint Inquiry form should be used in cases involving the reporting of a violation of a labor and/or human rights law and issues such as breaks, pay stubs, and the receipt of a final paycheck where the amount of the wages is not in dispute. A Complaint Inquiry form should not be used for the collection of wages due or to file an individual complaint of discrimination. To file a claim for wages, use Form 17081. To file a complaint of discrimination concerning employment, use Form 14543. To file a complaint of discrimination concerning housing, use Form 52229. To file a complaint of discrimination concerning public services/public accommodations, use Form 52974. The Complaint Inquiry form should be completed either by someone directly affected by the situation or someone who has directly witnessed the situation. Please complete all items on the form. No action will be taken on incomplete or unsigned forms. If the space provided on the form for an explanation is insufficient, feel free to attach additional pages. Also, provide any available documentation to support the complaint with the completed form. |
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