North Dakota Employment Discrimination Charge Preparation Worksheet
NORTH DAKOTA EMPLOYMENT DISCRIMINATION CHARGE PREPARATION WORKSHEET
Before you use this: State law requires a department complaint to be written in the form the Department prescribes. Use the Department's Employment Discrimination Intake and follow its current charge instructions. This worksheet does not start the filing process. For employment discrimination, N.D.C.C. § 14-02.4-19(2) generally gives 300 days from the alleged act to file a department complaint or begin the specified district-court action. Seek help promptly if a deadline may be close.
People and employment
Your full name and private contact details: [________________________________]
Employer's legal name, address, and phone: [________________________________]
Your position or application and work dates: [________________________________]
Decision makers and their roles, if known: [________________________________]
Events to transfer to the official intake
Describe the conduct with dates and the facts you personally know. Identify documents and witnesses without placing private medical records in this worksheet.
| Date | Decision or conduct | Person involved | Record or witness |
|---|---|---|---|
| [__/__/____] | [FACTS] | [NAME AND ROLE] | [RECORD OR WITNESS] |
| [__/__/____] | [FACTS] | [NAME AND ROLE] | [RECORD OR WITNESS] |
Date of the alleged act: [__/__/____]
Characteristic or activity you believe was involved under N.D.C.C. § 14-02.4-03(1): [RACE / COLOR / RELIGION / SEX / NATIONAL ORIGIN / AGE / PHYSICAL OR MENTAL DISABILITY / MARITAL STATUS / PUBLIC ASSISTANCE STATUS / LAWFUL OFF-DUTY ACTIVITY / OTHER CLAIM IDENTIFIED BY COUNSEL]
Facts connecting the decision to that characteristic or activity:
[____________________________________________________________]
If you requested an accommodation, what did you ask for, when, and what response did you receive?
[____________________________________________________________]
What reason did the employer give, if any? [________________________________]
What outcome are you asking the Department to consider? [________________________________]
Filing record
☐ Transfer your facts to the Department's current online intake route. Follow any later instructions the Department gives for the prescribed written complaint.
☐ Keep a copy and proof of what was sent. Ask the Department to confirm the date it received a complaint in the prescribed form.
Intake submitted: [__/__/____] Complaint filing date confirmed by Department: [__/__/____]
Official sources
About this template
- Last updated
- November 3, 2026
- Citations checked
- November 3, 2026
- Jurisdiction
- North Dakota
- Category
- Employment & HR
Legal authority
- N.D.C.C. § 14-02.4-03(1)-(2)
- N.D.C.C. § 14-02.4-19(2)
- N.D.C.C. § 14-02.4-23(1)
Employment documents govern the relationship between a company and its workers, from offer letters and employment agreements through handbooks, performance reviews, and separations. Done right, they set clear expectations, protect against wrongful termination and discrimination claims, and give both sides a record to rely on. Done poorly, they invite lawsuits, agency complaints, and costly disputes.
Not legal advice
This template is provided for informational purposes. We recommend having an attorney review any legal document before signing, especially for high-value or complex matters.
Checked against the law it cites
A reviewer verified this template's legal citations against the official source on November 3, 2026.
N.D.C.C. § 14-02.4-03(1) (checked November 3, 2026): "It is a discriminatory practice for an employer to fail or refuse to hire an individual; to discharge an employee; or to accord adverse or unequal treatment to an individual or employee with respect to application, hiring, training, apprenticeship, tenure, promotion, upgrading, compensation, layoff, or a term, privilege, or condition of employment, because of race, color, religion, sex, national origin, age, physical or mental disability, status with respect to marriage or public assistance, or participation Page No. 2 in lawful activity off the employer's premises during nonworking hours which is not in direct conflict with the essential business-related interests of the employer."
N.D.C.C. § 14-02.4-03(2) (checked November 3, 2026): "It is a discriminatory practice for an employer to fail or refuse to make reasonable accommodations for an otherwise qualified individual with a physical or mental disability, because that individual is pregnant, or because of that individual's religion."
N.D.C.C. § 14-02.4-19(2) (checked November 3, 2026): "Any person claiming to be aggrieved by any discriminatory practice other than public services or public accommodations in violation of this chapter may file a complaint of discriminatory practice with the department or, except as limited by this section, may bring an action in the district court in the judicial district in which the unlawful practice is alleged to have been committed, in the district in which the records relevant to the practice are maintained and administered, or in the district in which the person would Page No. 6 have worked or obtained credit were it not for the alleged discriminatory act within three hundred days of the alleged act of wrongdoing."
N.D.C.C. § 14-02.4-23(1) (checked November 3, 2026): "A complaint must be in writing and in the form prescribed by the department."
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