Forms

EEOC + OFO Forms

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.







➤ 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.



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.