Fillable City of Plattsburgh New York State Labor Law (City of Plattsburgh)

Fill Online, Printable, Fillable, Blank City of Plattsburgh New York State Labor Law (City of Plattsburgh) Form

Use Fill to complete blank online CITY OF PLATTSBURGH (NY) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

City of Plattsburgh New York State Labor Law (City of Plattsburgh)

On average this form takes 8 minutes to complete

The City of Plattsburgh New York State Labor Law (City of Plattsburgh) form is 2 pages long and contains:

  • 1 signature
  • 7 check-boxes
  • 23 other fields

Country of origin: US
File type: PDF

U.S.A. forms for City of Plattsburgh

BROWSE CITY OF PLATTSBURGH (NY) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
Adoption of this form does not constitute a conclusive defense to charges of unlawful sexual harassment. Each claim of
sexual harassment will be determined in accordance with existing legal standards, with due consideration of the particular
facts and circumstances of the claim, including but not limited to the existence of an effective anti-harassment policy and
procedure.
Page 1 of 3
City of Plattsburgh
New York State Labor Law requires all employers to adopt a sexual harassment prevention policy that
includes a complaint form to report alleged incidents of sexual harassment.
If you believe that you have been subjected to sexual harassment, you are encouraged to complete this form
and submit it to Senior Payroll Personnel Associate contact person, Julie Winterbottom. You will not be
retaliated against for filing a complaint.
If you are more comfortable reporting verbally or in another manner, your employer should complete this
form, provide you with a copy and follow its sexual harassment prevention policy by investigating the claims
as outlined at the end of this form.
For additional resources, visit: ny.gov/programs/combating-sexual-harassment-workplace
COMPLAINANT INFORMATION
Name:
Work Address: Work Phone:
Job Title: Email:
Select Preferred Communication Method: Email Phone In person
SUPERVISORY INFORMATION
Immediate Supervisor’s Name:
Title:
Work Phone: Work Address:
Model Complaint Form for
Reporting Sexual Harassment
_____________________________________________________________________
_________________________
__________________________
____________________________
_______________________________
_________________________________________________
_____________________________________________________________________
________________________
_________________________
Page 2 of 3
COMPLAINT INFORMATION
1. Your complaint of Sexual Harassment is made about:
Name: Title:
Work Address: Work Phone:
Relationship to you: Supervisor Subordinate Co-Worker Other
2. Please describe what happened and how it is affecting you and your work. Please use additional
sheets of paper if necessary and attach any relevant documents or evidence.
3. Date(s) sexual harassment occurred:
Is the sexual harassment continuing? Yes No
4. Please list the name and contact information of any witnesses or individuals who may have
information related to your complaint:
The last question is optional, but may help the investigation.
5. Have you previously complained or provided information (verbal or written) about related
incidents? If yes, when and to whom did you complain or provide information?
If you have retained legal counsel and would like us to work with them, please provide their contact
information.
Signature: __________________________ Date: __________________
___________________________
_________________________________
______________________
__________________________
__________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
_________________________________________________________________________
click to sign
signature
click to edit
Page 3 of 3
Instructions for Employers
If you receive a complaint about alleged sexual harassment, follow your sexual harassment
prevention policy.
An investigation involves:
• Speaking with the employee
• Speaking with the alleged harasser
• Interviewing witnesses
• Collecting and reviewing any related documents
While the process may vary from case to case, all allegations should be investigated promptly and
resolved as quickly as possible. The investigation should be kept confidential to the extent possible.
Document the findings of the investigation and basis for your decision along with any corrective
actions taken and notify the employee and the individual(s) against whom the complaint was made.
This may be done via email.
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

City of Plattsburgh New York State Labor Law (City of Plattsburgh)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 21 January 2021

Message

View Audit Log
Print With Audit Log
Duplicate Document