INFORMATION CONCERNING THE PROCESSING OF YOUR COMPLAINT
This form should be used if you, as an employee or applicant for employment with the U.S. Department of State, believe that you have
been discriminated against because of your race, color, national origin, sex (including pregnancy and gender identity), religion, age,
physical or mental disability, protected genetic information, sexual orientation, or reprisal for prior EEO activity or reprisal for prior EEO
activity or opposition to illegal discrimination.
Your written complaint must be filed within 15 CALENDAR DAYS of the date you received a "Notice of Right to File a Complaint."
Failure to submit a timely complaint can result in the dismissal of your formal complaint in accordance with 29 C.F.R. § 1614.107.
Your EEO Counselor is not authorized to receive your formal complaint on behalf of the Office of Civil Rights (S/OCR). Your
complaint must be submitted directly to S/OCR by email, fax or mail at the contact information provided below.
Instruction Page 1 of 1
READ INSTRUCTIONS CAREFULLY
U.S. Department of State
2201 C Street, NW, Room 7428
Washington, DC 20520-7428
Submitting your complaint by email is the recommended method to ensure prompt processing of your formal complaint. If
filing by mail, please allow at least 15 calendar days for receipt.
Please be specific in stating the facts concerning your complaint when completing this form. Keep in mind that you may agree to
resolve your complaint at any stage in the process. Also, you may have a representative at all stages of the processing of your
If your complaint is dismissed, you will be advised in writing of the reason(s) and informed of your right to appeal to the Equal
Employment Opportunity Commission (EEOC).
If your complaint is accepted, you will have an opportunity to talk with an investigator and to give him/her all the testimonial and
documentary evidence that you believe will support your complaint. Upon completion of the investigation of your complaint, you will
receive a copy of the investigative file. At that time you may request either: (1) an immediate final decision from the Department of
State based on the evidence in the file, or (2) a hearing and decision from an EEOC Administrative Judge.
The Director for Civil Rights issues a Final Agency Decision based on the file or a Final Order based on a decision from the EEOC. If
you are not satisfied with the agency's decision or Final Order, you will have the right to file an appeal with the EEOC's Office of
EEOC Office of Federal Operations
P.O. Box 77960
Washington, DC 20013
To be timely, you must file your appeal within 30 calendar days of your receipt of the Final Agency Decision or Final
For questions concerning the discrimination complaint process or completion of this form, contact S/OCR by using the contact
information listed above.