COMPLAINANT INFORMATION
(*) indicates a required field.
PERSON/LOCATION NAMED IN COMPLAINT
Address of unit or office
BASIS OF ALLEGED DISCRIMINATION (Reason for discrimination)
Check appropriate box(es)
TERMS/CONDITIONS OF ALLEGED DISCRIMINATION (Harm Alleged)
Check appropriate box(es)
EXPLANATION
(Please briefly describe with detail the circumstances that cause you to believe you have been discriminated against, harassed or sexually harassed, including dates, please, persons involved and witnesses)
This field contains a maximum character limit of 8,000. If your information exceeds this amount, or you have additional information to attach, please submit via eeocomplaints@dot.state.fl.us