Wyoming Employment Discrimination Intake Preparation Worksheet
WYOMING EMPLOYMENT DISCRIMINATION INTAKE PREPARATION WORKSHEET
Use the agency's forms: The Wyoming Fair Employment Program (WFEP) posts general and disability intake questionnaires. Transfer your answers to its current questionnaire. The agency says a compliance officer reviews the intake, prepares a charge draft, and asks you to sign and notarize the draft before returning it. This worksheet and the intake questionnaire are preparation steps; neither replaces the verified complaint required by Wyo. Stat. § 27-9-106(a).
Time to act: Section 27-9-106(a) requires filing the verified written complaint with the department within six months of the alleged violation. Work backward from the event date to allow time for agency drafting and notarization. Ask the agency promptly how and when it receives the completed charge. A separate federal claim or deadline needs its own review.
1. People and workplace
Your legal name: [________________________________]
Safe mailing address: [________________________________]
Phone and email where the agency may contact you: [________________________________]
Employer, employment agency, or labor organization you believe acted unlawfully: [________________________________]
Worksite and mailing address of that organization: [________________________________]
Supervisor or human resources contact, if known: [________________________________]
Your position, work location, and employment dates: [________________________________]
Approximate number of the employer's Wyoming employees, if known: [________]
2. Conduct and dates
The Wyoming statute identifies these possible employment grounds. Select only those supported by your facts:
☐ Age, if at least 40 ☐ Sex ☐ Race ☐ Creed ☐ Color ☐ National origin ☐ Ancestry ☐ Pregnancy ☐ Qualified disability ☐ Off-duty tobacco use or nonuse
Other ground you want counsel or the agency to assess under a separate law: [________________________________]
Most recent alleged act and date: [________________________________]
Earlier related acts and dates: [________________________________]
Describe each event with the decision maker, what happened, and why you connect it to the selected ground:
| Date | Person and action | Effect on your work | Facts connecting the action to a selected ground |
|---|---|---|---|
| [DATE] | [FACTS] | [EFFECT] | [FACTS] |
| [DATE] | [FACTS] | [EFFECT] | [FACTS] |
Explanation the organization gave, if any: [________________________________]
What outcome do you seek? [________________________________]
3. Documents and witnesses
People who saw the events or have relevant information, with safe contact details: [________________________________]
Records to preserve: ☐ application or offer ☐ schedule ☐ pay records ☐ reviews or discipline ☐ accommodation requests ☐ messages ☐ other [________________________________]
For each record, note its date, source, and what it shows: [________________________________]
Earlier report to the organization or another agency, with date and response: [________________________________]
4. Agency process record
☐ Open the current WFEP forms page; use its general questionnaire or disability questionnaire as appropriate. Follow the agency's submission instructions.
Questionnaire sent by [METHOD] on [DATE]; receipt or contact person: [________________________________]
☐ Review the agency's charge draft for names, dates, facts, and requested correction. Ask for changes before signing if it is inaccurate.
☐ Sign and notarize the agency charge as instructed, then return it in time for the six-month statutory filing period. Confirm filing with WFEP.
Charge returned by [METHOD] on [DATE]; agency filing confirmation: [________________________________]
Keep the questionnaire, charge, delivery proof, and supporting records. Use the agency's charge process for filing; do not submit this worksheet as a charge.
Official sources
About this template
- Last updated
- November 2, 2026
- Citations checked
- November 2, 2026
- Jurisdiction
- Wyoming
- Category
- Civil Rights
Legal authority
- Wyo. Stat. § 27-9-102(b) (covered employer)
- Wyo. Stat. § 27-9-105(a)-(b) (state employment practices and age coverage)
- Wyo. Stat. § 27-9-106(a) (verified complaint and six-month filing period)
Civil rights cases address violations of your constitutional or federally protected rights by government officials, employers, landlords, or businesses. Most of these claims come with short deadlines and specific filing requirements. Well-drafted complaints and demand letters identify the right law, name the right parties, and preserve your claims before the clock runs out.
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 2, 2026.
Wyo. Stat. § 27-9-102(b) (checked November 2, 2026): "every other person employing two (2) or more employees within the state"
Wyo. Stat. § 27-9-105(a)-(b) (checked November 2, 2026): "because of age, sex, race, creed, color, national origin, ancestry or pregnancy"
Wyo. Stat. § 27-9-106(a) (checked November 2, 2026): "within six (6) months of the alleged violation a verified, written complaint"
Wyoming Department of Workforce Services, Workers & Job Seekers (checked November 2, 2026): "A Compliance Officer reviews your info and sends you a formal “Charge Draft.”"
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