Vermont State Civil Rights Complaint (FEPA / Public Accommodations)

Vermont Civil Rights Updated September 27, 2026 Free Word and PDF

State of Vermont — Superior Court, Civil Division

Unit [________________] Unit
Docket number [________________]
Plaintiff [FULL LEGAL NAME]
Defendant(s) [EXACT LEGAL NAME(S)]

Complaint for Violation of Vermont Civil Rights Law

Plaintiff alleges the following on personal knowledge as to Plaintiff's own acts and on information and belief as to other matters:

Parties, Jurisdiction, and Venue

  1. Plaintiff [NAME] resides in [TOWN, STATE] and is [DESCRIBE RELEVANT EMPLOYEE OR PUBLIC-ACCOMMODATION STATUS].

  2. Defendant [NAME] is [LEGAL FORM AND ADDRESS]. At the relevant times Defendant [DESCRIBE EMPLOYER, EMPLOYMENT AGENCY, LABOR ORGANIZATION, OR PUBLIC-ACCOMMODATION ROLE FOR EACH SELECTED COUNT].

  3. This Court has authority to hear the selected state-law claim under [21 V.S.A. § 495b(b) / 9 V.S.A. § 4506(a)]. Venue lies in this unit under [12 V.S.A. § 402(a) FOR EMPLOYMENT / 9 V.S.A. § 4506(a) FOR PUBLIC ACCOMMODATION] because [PARTY RESIDENCE OR COUNTY OF ALLEGED VIOLATION; PLEAD EACH APPLICABLE BASIS].

Common Facts

  1. On [DATE], at [LOCATION], [PERSON] did [SPECIFIC ACTION OR STATEMENT].

  2. Plaintiff's relevant protected characteristic or activity was [EXACT CHARACTERISTIC OR ACTIVITY UNDER THE SELECTED STATUTE]. The facts showing Defendant knew of it, where knowledge is part of the claim, are [FACTS].

  3. The facts connecting the protected characteristic or activity to the challenged act are [CHRONOLOGY, STATEMENTS, DOCUMENTS, OR OTHER FACTS].

  4. Plaintiff experienced [SPECIFIC LOSS, DENIAL, EXCLUSION, OR OTHER HARM]. Supporting records and witnesses include [IDENTIFY].

Count I — Employment Discrimination or Harassment, 21 V.S.A. § 495(a)(1)

  1. Plaintiff incorporates paragraphs [____] through [____].

  2. Defendant is a covered [EMPLOYER / EMPLOYMENT AGENCY / LABOR ORGANIZATION] because [SPECIFIC COVERAGE FACTS; FOR AN EMPLOYER, IDENTIFY INDIVIDUALS PERFORMING SERVICES IN VERMONT UNDER § 495d(1)]. Plaintiff is [EMPLOYEE OR OTHER COVERED INDIVIDUAL AND FACTS].

  3. Defendant [HARASSED / DISCRIMINATED AGAINST] Plaintiff because of [EXACT § 495(a)(1) BASIS] by [SPECIFIC ACTS, DATES, AND ACTORS].

  4. If harassment is alleged, the conduct was more than a petty slight or trivial inconvenience to a reasonable employee with the same protected characteristic because [CONTEXT AND FACTS]. Section 495(k) does not require harassment or discrimination to be severe or pervasive.

  5. As a result, Plaintiff sustained [SPECIFIC INJURIES AND LOSSES].

Count II — Employment Retaliation, 21 V.S.A. § 495(a)(8)

  1. Plaintiff incorporates paragraphs [____] through [____].

  2. Plaintiff [OPPOSED A PROHIBITED PRACTICE / COMPLAINED OR PARTICIPATED IN AN IDENTIFIED GOVERNMENT INVESTIGATION / WAS KNOWN TO BE ABOUT TO DO SO / DISCLOSED OR DISCUSSED WAGES / WAS BELIEVED TO HAVE DONE ONE OF THESE ACTS] on [DATE] by [FACTS].

  3. Defendant [NAME OF COVERED EMPLOYER, AGENCY, OR ORGANIZATION] knew or believed [FACTS] and, because of that activity, [DISCHARGED OR OTHERWISE DISCRIMINATED AGAINST] Plaintiff by [ACTS AND DATES].

  4. As a result, Plaintiff sustained [SPECIFIC INJURIES AND LOSSES].

Count III — Public-Accommodation Discrimination, 9 V.S.A. § 4502

  1. Plaintiff incorporates paragraphs [____] through [____].

  2. [FACILITY] offers [GOODS, SERVICES, FACILITIES, OR BENEFITS] to the public. Defendant [OWNS / OPERATES / ACTED AS OWNER'S OR OPERATOR'S AGENT OR EMPLOYEE] there.

  3. Because of Plaintiff's [EXACT BASIS LISTED IN § 4502(a) / DISABILITY UNDER § 4502(c)], Defendant [REFUSED, WITHHELD, DENIED, EXCLUDED, OR OTHERWISE DISCRIMINATED] by [SPECIFIC FACTS, DATES, AND ACTORS].

  4. The alleged violation occurred in [COUNTY] County. Plaintiff sustained [SPECIFIC INJURIES AND LOSSES].

Request for Relief

Plaintiff asks for judgment against [DEFENDANT(S) FOR EACH COUNT] granting the following relief to the extent supported by the selected claim and proved facts:

  1. [SPECIFIED INJUNCTIVE OR OTHER EQUITABLE RELIEF];
  2. Compensatory damages in an amount proved at trial;
  3. Punitive damages, if supported by the facts and applicable law;
  4. [FOR A FEPA CLAIM, IDENTIFIED BACK PAY, BENEFITS, OR REINSTATEMENT, IF APPLICABLE];
  5. Costs and reasonable attorney's fees as authorized by [§ 495b(b) / § 4506(b)]; and
  6. Other appropriate relief authorized by the selected statute.

Respectfully submitted,

Date: [__/__/____]

Signature: [________________________________]

Printed name and Vermont bar number, if counsel: [________________________________]

Address, telephone, and email: [________________________________]

Sources

  • 21 V.S.A. § 495: https://legislature.vermont.gov/statutes/section/21/005/00495
  • 21 V.S.A. § 495b: https://legislature.vermont.gov/statutes/section/21/005/00495b
  • 21 V.S.A. § 495d: https://legislature.vermont.gov/statutes/section/21/005/00495d
  • 9 V.S.A. § 4502: https://legislature.vermont.gov/statutes/section/09/139/04502
  • 9 V.S.A. § 4506: https://legislature.vermont.gov/statutes/section/09/139/04506
  • 12 V.S.A. § 402: https://legislature.vermont.gov/statutes/section/12/021/00402

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About this template

Last updated
September 27, 2026
Citations checked
September 27, 2026
Jurisdiction
Vermont
Category
Civil Rights

Legal authority

  • 21 V.S.A. § 495(a)(1), (a)(8), (c), (j), (k)
  • 21 V.S.A. § 495b(b)
  • 21 V.S.A. § 495d(1), (2), (6)
  • 9 V.S.A. § 4502(a), (c)
  • 9 V.S.A. § 4506(a), (b), (d)
  • 12 V.S.A. § 402(a)

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 September 27, 2026.

21 V.S.A. § 495 (checked September 27, 2026): "For any employer, employment agency, or labor organization to harass or discriminate against any individual because of race, color, religion, ancestry, national origin, sex, sexual orientation, gender identity, place of birth, crime victim status, or age or against a qualified individual with a disability."

21 V.S.A. § 495b (checked September 27, 2026): "Any person aggrieved by a violation of the provisions of this subchapter may bring an action in Superior Court seeking compensatory and punitive damages or equitable relief, including restraint of prohibited acts, restitution of wages or other benefits, reinstatement, costs, reasonable attorney’s fees, and other appropriate relief."

21 V.S.A. § 495d (checked September 27, 2026): "that has one or more individuals performing services for it within this State."

9 V.S.A. § 4502 (checked September 27, 2026): "An owner or operator of a place of public accommodation or an agent or employee of such owner or operator shall not, because of the race, creed, color, national origin, citizenship, immigration status, marital status, sex, sexual orientation, or gender identity of any person, refuse, withhold from, or deny to that person any of the accommodations, advantages, facilities, and privileges of the place of public accommodation."

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