Department of Civil Rights

Velma J. Korbel, Director

350 S. 5th St., Room 239
Minneapolis, MN 55415

Phone: (612) 673-3012
Fax: (612) 673-2599
TTY: (612) 673-2157

Office of Police Conduct Review
(612) 673-5500

Office Hours:
8:30 a.m.–4:30 p.m.
Monday – Friday

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File A Discrimination Complaint

If you feel that you have been discriminated against and the alleged act of discrimination occurred in the City of Minneapolis within the last 365 days in violation of the City's Civil Rights Ordinance or the Federal Civil Rights Act of 1964 and would like to request to file a charge of discrimination, please fill out the complaint request below.

It is necessary for the investigator to be able to contact you in order to follow up on your request. Please provide the following information for that purpose. Information related to the complaint is confidential and will not be released to the public.

Personal Information














 

Area/Basis for Claim of Discrimination

In what area do you feel you were discriminated?

(Definition of Terms)

What is the basis for your claim? (Check all that apply & give specifics in the related textbox)

Race
Color
Religion
Age
Disability
Ancestry
Creed
Sex
Gender Identity
Sexual Orientation
Sexual Harassment
Marital Status
Public Assistance
National Origin  
Familial Status
Registered Domestic Partner
 

 

Do you have attorney representation?




 

Have you filed a complaint with any other agency?

If yes, please answer below:




 

Do you plan to file a court action?

 

The Organization that I am complaining about is:











Complete this portion ONLY if Employment Discrimination Claim

Fewer than 15
15-100
100+
Unknown

Your Employment Information




Discharge
Lay-off
Quit


 

Witnesses




 

I hereby certify that the information in this complaint is true and accurate to the best of my knowledge and belief. I understand that this is the first step to initiating a Charge of Discrimination and that I may be requested to provide further information. You must certify that the information in this complaint is true and accurate to the best of your knowledge. Please check the box.

Information you provide is subject to the Minnesota Government Data Practices Act. This law classifies certain information as available to the public on request.

Last updated Jan. 4, 2013