EEOC Complaint

IN THE UNITED STATES DISTRICT COURTFOR THE SOUTHERN DISTRICT OF ALABAMA :Plaintiff, :vs. :Civil Action No. : :Defendant(s) :COMPLAINT 1. Plaintiff resides at 2. Name(s) of defendant(s) 3. Location of principal office(s) of the named defendant(s) 4. Nature of business of defendant(s) 5. Approximate number of individuals employed by defendant(s) 6. The acts complained of in this suit concern: (A) Failure to employ me. (B) Termination of my employment. (C) Failure to promote me. (D) Other acts as specified below: American LegalNet, Inc. www.FormsWorkFlow.com 7. Plaintiff is: (A) Presently employed by the defendant. (B) Not presently employed by the defendant. The dates of employment were (1) Plaintiff was discharged. (2) Plaintiff was laid off. (3) Plaintiff left the job voluntarily.8. Defendant(s) discriminated against me on account of my: (A) Race Sex Color National Origin Religion Therefore, I am bringing this action for employment discrimination pursuant to Title VIIof the Civil Rights Act of 1964, specifically, 42 U.S.C. 247 2000e-5. (B) Physical disability Mental disabilityTherefore, I am bringing this action pursuant to the American with Disabilities Act,specifically, 42 U.S.C. 247 12117. (C) AgeTherefore, I am bringing this action pursuant to the Age Discrimination in EmploymentAct of 1967, specifically, 29 U.S.C. 247 626.9. The name(s), race, sex, and the position or title of the individual(s) who allegedlydiscriminated against me during the period of my employment with the defendant company is(are) 10. The alleged discrimination occurred on or about 11. The nature of my complaint, i.e., the manner in which the individual(s) named above American LegalNet, Inc. www.FormsWorkFlow.com discriminated against me in terms of the conditions of my employment, is as follows: 12. The alleged illegal activity took place at 13. I filed charges with the Equal Employment Opportunity Commission regarding allegeddiscriminatory conduct by defendant(s) on or about I have attached a copy of the Notice-of-Right-to-Sue letter issued by the Equal EmploymentOpportunity Commission. This letter was received by me on 14. I seek the following relief: (A) Recovery of back pay. (B) Reinstatement to my former job, and any other relief as may be appropriate,including injunctive orders, damages, costs and attorney222s fees. Date: Signature of Plaintiff Address of Plaintiff( ) Telephone Number of Plaintiff American LegalNet, Inc. www.FormsWorkFlow.com