EEOC Forms:

➤ EEOC Charge Form (5)

• Note: For private employment discrimination case only; not for federal employment case.

➤ Request for an EEOC Hearing Form

• Appendix N EEO-MD-110, for federal case only, to be sent after receiving the Report of Investigation (ROI). See Federal EEO process for more information

➤ Designation of Representative for EEOC hearing

• For establishing contact with EEO Counselor to file discrimination complaint in federal employment and for notifying your representative.

➤ Complainant Affidavit

➤ Complainant Affidavit (for USPS)

➤ Witness Affidavit

➤ Certificate of Service

➤ Verification or Declaration

➤ Interrogatories, request for production of documents, and request for admission (blank)

➤ Medical Questionnaire on Disabilities

• A sample to be sent to your doctor to verify your disabilities.

➤ Authorization to Release Medical Information

• A blank form to be used to request medical document from your doctor.

➤ Motion to EEOC Judge (blank form)

➤ Motion to Amend and to Consolidate the Charge (EEOC hearing)

OFO Forms:

➤ Notice of Appeal/Petition to Office of Federal Operations (EEOC Form 573)

• To appeal the Final Agency Decision (FAD) to the Office of Federal Operations (OFO) in DC (only for federal employment case; see federal EEO process for more information)

➤ A Sample of OFO appeal brief

• To be submitted with or within 30 days after submitting Notice of Appeal/Petition to Office of Federal Operations)

Disclaimer

• Mr. Lee is not an attorney but can represent clients in federal administrative processes, including EEOC hearings and MSPB hearings.
• Mr. Lee does not practice law and cannot provide attorney-client protection privileges.  However, as any union shop steward can, Mr. Lee can represent federal employees at any administrative proceeding including those referenced above.
• Mr. Lee cannot and does not represent clients at court proceedings.