Discrimination Report
Employment Complaint Information
Use this form if:
- • You are an employee, an applicant, a domestic worker, an intern, or a volunteer reporting discrimination by an employer.
- • You are a non-employee who experienced discrimination while working at an employer's worksite.
- • You faced discrimination from a union, an employment agency, or temporary employment agency.
- • You were denied a license by a licensing agency. This includes, but is not limited to, a security guard license, a cosmetology license, a landscape architecture license, a liquor license, and more.
Housing Complaint Information
Use this form if:
- • You experienced housing discrimination from a landlord, management company, property seller, real estate professional, or anyone having the right to sell, lease or rent housing, or anyone working at one of these entities if they personally discriminated against you.
- • You experienced discrimination related to the purchase or lease of land or commercial space.
- • You were denied housing-related credit (like a mortgage or a home equity line of credit) for a discriminatory reason.
Educational Institution Complaint Information
Use this form if you are a current student, a former student, or have applied to be a student, and you experienced discrimination at:
- • A public school, including public school districts, charter school, Boards of Cooperative Educational Services (BOCES), public colleges and universities, universal Pre-K, Head Start or other publicly funded pre-kindergarten program.
- • A for-profit college.
- • A private school at any education level, EXCEPT this does not apply to:
- ○ For-profit schools for grades pre-kindergarten through high school, and
- ○ Schools run by a faith organization.
Do not use this form if:
- • You are employed by a school and are reporting discrimination as an employee. Use the Employment form instead.
- • You experienced discrimination at a day care center. Use the Public Accommodation form instead.
Public Accommodation Complaint Information
Use this form if you experienced discrimination as a customer or client of any entity that offers goods or services to the public.
This includes, but is not limited to, stores, insurance agencies, theatres, restaurants, transportation services, public buildings, salons, medical offices, day care services, parks, fitness and recreation facilities, including any recreational facilities owned or operated by a governmental entity.
Do not use this form if:
- • You were denied a mortgage or other housing-related credit. Use the Housing form instead.
- • You were denied benefits from your employer, including insurance. Use the Employment form instead.
Boycotting or Blacklisting Complaint Information
Use this form to report discrimination by a business or organization that refused to buy from, sell to, trade with, or otherwise refuses to do business with you, your business, or organization, for a discriminatory reason.
Volunteer Firefighters Complaint Information
Use this form to report discrimination you experienced as a volunteer firefighter by your fire department or fire company.
Credit Complaint Information
Use this form if you were denied credit, like a credit card or a student loan, for a discriminatory reason.
Note: If the credit you were denied relates to a mortgage, use the Housing form.