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New York State Division of Human Rights Complaint Form

Instructions

1) Please fill out the complaint form, answering all questions to the best of your ability. Required questions are marked with an asterisk. Failure to answer the required questions will prevent you from proceeding to the next question. A delay could occur in the investigation of your complaint if the form is not filled out properly or if the information provided in the complaint is incomplete.

2) If you prefer to print and fill out a printed form, please visit our website at www.dhr.ny.gov/complaint.

3) Please make sure to click “Submit” once you have finished completing the form and are ready to send. We recommend that you review your form before hitting submit, to ensure that you have included everything that you wanted to include as part of your complaint.

4) You will receive a confirmation email after your submission. Keep the confirmation email for your own records.

5) After the Division accepts your complaint, it will be sent to the company or person(s) whom you are charging with discrimination. 

Time Limit for Filing

Please note: You must file your complaint within one year of the most recent act of alleged discrimination. If you were terminated, you must file within one year of the date you were first informed you would be terminated. If you are alleging sexual harassment in the workplace that occurred after 8/12/2020, you may file within three years from the most recent incident.

If you need further assistance, please call one of our offices, make an appointment for a personal meeting, or visit our website at www.dhr.ny.gov/complaint. If you require an accommodation to complete this form, please contact the Division’s Director of Disability Rights at 718-741-8332 or accessibility@dhr.ny.gov. Interpreter services are also available at no cost upon request.