Complaint For Employment Discrimination

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American LegalNet, Inc. www.FormsWorkFlow.com IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF SOUTH CAROLINA _________________________________________ _________________________________________ _________________________________________ (Write the full name of each plaintiff who is filing this complaint. If the names of all the plaintiffs cannot fit in the space above, please write "see attached" in the space and attach an additional page with the full list of names.) -against_________________________________________ _________________________________________ _________________________________________ (Write the full name of each defendant who is being sued. If the names of all the defendants cannot fit in the space above, please write "see attached" in the space and attach an additional page with the full list of names.) Complaint for Discrimination Employment Case No. _______________________ (to be filled in by the Clerk's Office) Jury Trial: Yes No (check one) I. The Parties to This Complaint A. The Plaintiff(s) Provide the information below for each plaintiff named in the complaint. Attach additional pages if needed. Name Street Address City and County State and Zip Code Telephone Number __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ American LegalNet, Inc. www.FormsWorkFlow.com B. The Defendant(s) Provide the information below for each defendant named in the complaint, whether the defendant is an individual, a government agency, an organization, or a corporation. For an individual defendant, include the person's job or title (if known). Attach additional pages if needed. Defendant No. 1 Name Job or Title (if known) Street Address City and County State and Zip Code Telephone Number Defendant No. 2 Name Job or Title (if known) Street Address City and County State and Zip Code Telephone Number Defendant No. 3 Name Job or Title (if known) Street Address City and County State and Zip Code Telephone Number Defendant No. 4 Name Job or Title (if known) __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ __________________________________________ 2 American LegalNet, Inc. www.FormsWorkFlow.com Street Address City and County State and Zip Code Telephone Number C. Place of Employment __________________________________________ __________________________________________ __________________________________________ __________________________________________ The address at which I sought employment or was employed by the defendant(s) is: Name Street Address City and County State and Zip Code Telephone Number II. Basis for Jurisdiction This action is brought for discrimination in employment pursuant to (check all that apply): Title VII of the Civil Rights Act of 196