Report Discrimination

Please complete this form to make a report of discrimination. You can make this report whether or not you wish to be involved in an official complaint.

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Your Name:

Your Address:

Your Email:

Your Phone:

Category of Discrimination: *

Name of the person(s) and/or business who discriminated against you or someone else: *

Address or general location of the person(s) and/or business: *

Phone number of the person(s) and/or business:

Date of most recent incident: *

Have you filed a complaint with us before? *

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Please explain the issue or problem: *

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Please check this box to acknowledge your understanding that filling out this form is not an official complaint with the NYC Commission on Human Rights. The New York City Human Rights Law allows a person who has experienced discrimination to file a complaint at the Law Enforcement Bureau of the City Commission on Human Rights within one year of the discriminatory practice (or three years for gender-based harassment). The Law allows three years to bring a complaint to court. You are responsible for monitoring this deadline, called the "statute of limitations." The statute of limitations does not stop until a verified complaint is signed, notarized, and mailed or personally delivered to the Law Enforcement Bureau. *

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