FCHR Charge of Discrimination — Florida Commission on Human Relations

CHARGE OF DISCRIMINATION

FLORIDA COMMISSION ON HUMAN RELATIONS

Agency: Florida Commission on Human Relations ("FCHR")

Address: 4075 Esplanade Way, Room 110, Tallahassee, Florida 32399-7020

Telephone: (850) 488-7082 | Toll-Free: 1-800-342-8170 | Fax: (850) 487-1007

Web: https://fchr.myflorida.com/

FCHR Charge No.: [________________________________]

Cross-Filed EEOC No.: [________________________________]

Date Filed: [__/__/____]

TABLE OF CONTENTS

1. Charging Party Information
2. Respondent Information
3. Basis of Discrimination (Protected Classes)
4. Date(s) of Alleged Discrimination and Continuing Action
5. Statement of Particulars
6. Comparator and Pretext Evidence
7. Damages Suffered
8. Remedies Requested
9. Dual Filing Election
10. Verification
11. Attorney Signature Block (if represented)
12. Filing Instructions and Cover Letter
13. Florida Practice Notes
14. Sources and References

1. CHARGING PARTY INFORMATION

2. RESPONDENT INFORMATION

3. BASIS OF DISCRIMINATION (PROTECTED CLASSES)

I believe I was discriminated against because of (check all that apply):

☐ Race — specify: [________________________________]

☐ Color — specify: [________________________________]

☐ Religion / Creed — specify: [________________________________]

☐ Sex / Gender — specify: [________________________________]

☐ Pregnancy

☐ National Origin / Ancestry — specify: [________________________________]

☐ Age (40 or over) — Date of Birth: [__/__/____]

☐ Disability / Handicap — specify: [________________________________]

☐ Marital Status

☐ Familial Status (housing)

☐ HIV / AIDS Status (Fla. Stat. § 760.50)

☐ Sickle-Cell Trait (Fla. Stat. § 448.075)

☐ Retaliation for protected activity — specify protected activity: [________________________________]

☐ Other (specify): [________________________________]

Forum of Discrimination:

☐ Employment ☐ Housing ☐ Public Accommodation ☐ Education

4. DATE(S) OF ALLEGED DISCRIMINATION AND CONTINUING ACTION

☐ Continuing Action — the discriminatory practice is continuing as of the date of this Charge.

5. STATEMENT OF PARTICULARS

Particulars of the Charge (use additional pages as necessary):

I. I, [CHARGING PARTY NAME], am a member of the protected class(es) of [specify]. I began [employment / tenancy / receiving service] with Respondent on or about [__/__/____] as a [position / role].

II. Throughout the relevant period I was qualified for and satisfactorily performed the duties of my [position / tenancy]. [Cite specific evidence: positive performance reviews, promotions, customer commendations, length of tenancy.]

III. Beginning on or about [__/__/____], I was subjected to the following discriminatory conduct:

• [Date / Incident #1]: [Describe — what happened, who was involved, where, what was said, witnesses.]
• [Date / Incident #2]: [Describe.]
• [Date / Incident #3]: [Describe.]

IV. I engaged in protected activity by [opposing the discrimination / filing internal complaint with HR / requesting reasonable accommodation / participating in an investigation] on or about [__/__/____]. Respondent had actual knowledge of my protected activity.

V. Shortly thereafter, Respondent took the following materially adverse action against me: [describe — termination, demotion, pay cut, reassignment, harassment, eviction, refusal of service] on [__/__/____].

VI. Respondent's stated reason for the adverse action — namely, [REASON GIVEN] — is false and pretextual because [explain].

VII. I believe that I have been discriminated against because of my [protected class] and/or in retaliation for my protected activity, in violation of Fla. Stat. § 760.10 [and Title VII / ADA / ADEA / FHA / Fla. Stat. § 760.23].

6. COMPARATOR AND PRETEXT EVIDENCE

Similarly Situated Comparators (treated more favorably):

Direct Evidence of Animus (statements, e-mails, text messages):

• [QUOTATION OR DESCRIPTION — speaker, date, context]
• [QUOTATION OR DESCRIPTION — speaker, date, context]

Witnesses to Discrimination:

7. DAMAGES SUFFERED

I have suffered the following damages as a result of Respondent's unlawful conduct:

☐ Lost wages and benefits — approximate amount: $[________]

☐ Lost overtime / commissions / bonuses — approximate amount: $[________]

☐ Loss of employer-provided health insurance and retirement contributions

☐ Out-of-pocket medical expenses — approximate amount: $[________]

☐ Emotional distress, anxiety, depression, sleep disruption, physical symptoms

☐ Damage to professional reputation

☐ Diminished earning capacity / career setback

☐ Loss of housing / displacement

☐ Other: [________________________________]

8. REMEDIES REQUESTED

I respectfully request that the Florida Commission on Human Relations:

☐ Investigate this Charge promptly under Fla. Stat. § 760.11(3) and issue a determination of reasonable cause;

☐ Conduct a fact-finding conference and/or attempt conciliation under Fla. Stat. § 760.11(4);

☐ Reinstate me to my prior position with full seniority and benefits, or order other equitable relief;

☐ Order back pay, front pay, and lost benefits;

☐ Award compensatory damages, including damages for mental anguish and loss of dignity, under Fla. Stat. § 760.11(5);

☐ Award punitive damages up to the $100,000 cap under Fla. Stat. § 760.11(5);

☐ Order reasonable accommodation: [describe];

☐ Order Respondent to implement remedial training and policy changes;

☐ Award attorney's fees and costs under Fla. Stat. § 760.11(5);

☐ Issue a Notice of Right to Sue if conciliation fails or if 180 days elapse without determination;

☐ Other relief: [________________________________].

9. DUAL FILING ELECTION

☐ YES — I elect to dual-file this Charge with the U.S. Equal Employment Opportunity Commission ("EEOC") pursuant to the FCHR/EEOC Work-Share Agreement and 29 C.F.R. § 1601.13. I understand that this preserves my federal rights under Title VII, the ADA, the ADEA, and GINA.

☐ YES — I also elect to dual-file with HUD pursuant to 24 C.F.R. § 103 if this Charge alleges housing discrimination.

☐ NO — I decline dual filing (NOT RECOMMENDED).

10. VERIFICATION

I, [CHARGING PARTY NAME], declare under penalty of perjury under the laws of the State of Florida and the United States of America that I have read the foregoing Charge of Discrimination and that the statements contained therein are true and correct to the best of my knowledge and belief.

[________________________________]

[CHARGING PARTY SIGNATURE]

Date: [__/__/____]

Notarization (Required by Fla. Stat. § 760.11(1)):

STATE OF FLORIDA

COUNTY OF [COUNTY]

Sworn to (or affirmed) and subscribed before me by means of ☐ physical presence or ☐ online notarization, this [____] day of [_______________], 20[____], by [CHARGING PARTY NAME], who is ☐ personally known to me or ☐ produced [IDENTIFICATION] as identification.

[________________________________]

Notary Public, State of Florida

(My Commission Expires: [_______________])

11. ATTORNEY SIGNATURE BLOCK (IF REPRESENTED)

[ATTORNEY NAME], Florida Bar No. [________]

[LAW FIRM NAME]

[STREET ADDRESS]

[CITY, FL ZIP]

Telephone: [____________]

E-mail: [__________________]

Counsel for Charging Party

12. FILING INSTRUCTIONS AND COVER LETTER

TRANSMITTAL — please use as cover letter when mailing:

[__/__/____]

Florida Commission on Human Relations

Attn: Intake Unit

4075 Esplanade Way, Room 110

Tallahassee, Florida 32399-7020

Re: Charge of Discrimination — [CHARGING PARTY NAME] v. [RESPONDENT NAME]

To Whom It May Concern:

Enclosed please find a verified Charge of Discrimination for filing pursuant to Fla. Stat. § 760.11. The Charge is timely filed within the 365-day window from the most recent discrete discriminatory act on [__/__/____]. Charging Party elects dual filing with the EEOC under the Work-Share Agreement and respectfully requests that the FCHR docket the Charge, assign a case number, and proceed with investigation.

Please direct all correspondence regarding this matter to the undersigned [/ to the Charging Party at the address above]. Thank you for your attention.

Respectfully,

[________________________________]

[ATTORNEY OR CHARGING PARTY NAME]

Enclosures: Verified Charge of Discrimination; supporting documentation (☐ termination letter; ☐ performance reviews; ☐ correspondence; ☐ comparator records; ☐ medical or accommodation documentation; ☐ other)

13. FLORIDA PRACTICE NOTES

• 365-day window — uniquely long. Fla. Stat. § 760.11(1) gives 365 days from the alleged violation, in contrast to the federal 180-day default and the 300-day extension that applies in deferral states under Title VII. Even when the EEOC's Notice of Right to Sue arrives, do not let the FCRA's 365-day window be missed; the longer state window may be the only viable path if federal exhaustion lapses.
• Verification is mandatory. A Charge filed under Fla. Stat. § 760.11(1) must be verified (signed under oath). An unverified intake form does not start the clock; ensure notarization or proper FCHR-portal e-verification.
• Continuing-violation doctrine. Hostile work environment claims may reach back beyond the 365-day window if at least one contributing act is timely. Nat'l R.R. Passenger Corp. v. Morgan, 536 U.S. 101 (2002); followed in pari materia by Florida courts.
• 180-day investigation period. FCHR has 180 days from filing to make a reasonable-cause determination. If FCHR fails to act within 180 days, Charging Party may proceed to circuit court "as if" cause were found and must sue within one year of FCHR's certification of mailing. Fla. Stat. § 760.11(8).
• 35-day administrative-hearing election. After a no-cause determination, Charging Party has 35 days to request a hearing under Fla. Stat. § 760.11(7); failure to request results in dismissal. After a cause determination, the Charging Party may instead file a civil action within one year. Fla. Stat. § 760.11(5)–(6).
• EEOC dual filing. Under the FCHR/EEOC Work-Share Agreement, a Charge filed with one agency is generally cross-filed with the other. Always elect dual filing in writing to preserve maximum remedies and to start both clocks.
• Coverage threshold. FCRA applies to employers with 15+ employees. Local ordinances in Miami-Dade, Broward, Palm Beach, Orange, Hillsborough, Duval, and other counties cover smaller employers and may include sexual orientation and gender identity (Florida statewide protections vary; Bostock v. Clayton County, 590 U.S. 644 (2020), reads sex to include sexual orientation and gender identity under Title VII, and Florida courts construe FCRA in pari materia).
• Housing charges. File on FCHR's housing-complaint form (or HUD Form 903) within one (1) year for HUD/FCHR administrative filing; circuit-court action lies within two (2) years under Fla. Stat. § 760.35(1).
• Public accommodation. Fla. Stat. § 760.08 covers public accommodations; "lodge halls and similar facilities" of bona fide private clubs are excluded.
• Confidentiality. FCHR investigative file is confidential and exempt from public records under Fla. Stat. § 760.11(11) until a determination is made.
• Government respondents. State and political-subdivision respondents are not liable for FCRA punitive damages. Sovereign-immunity caps under Fla. Stat. § 768.28 may apply to compensatory awards; consult before drafting damages requests.

14. SOURCES AND REFERENCES

• Florida Commission on Human Relations — Home — https://fchr.myflorida.com/
• FCHR — File a Complaint — https://fchr.myflorida.com/file-a-complaint-page
• FCHR — Contact Us — https://fchr.myflorida.com/contact/
• FCHR — Frequently Asked Questions — https://fchr.myflorida.com/faq-frequently-asked-questions
• Fla. Stat. § 760.11 (Administrative and Civil Remedies) — https://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0760/Sections/0760.11.html
• Fla. Stat. § 760.10 (Unlawful Employment Practices) — https://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0760/Sections/0760.10.html
• Fla. Stat. § 760.07 (Remedies) — https://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&URL=0700-0799/0760/Sections/0760.07.html
• Fla. Admin. Code Chapter 60Y (FCHR Rules) — https://www.flrules.org/gateway/Department.asp?DeptID=60
• EEOC — Filing a Charge of Discrimination — https://www.eeoc.gov/filing-charge-discrimination
• HUD — Fair Housing Complaint — https://www.hud.gov/topics/housing_discrimination
• Florida Bar Journal — "Defining the Hourglass — When Is a Claim Under the Florida Civil Rights Act Time Barred?" — https://www.floridabar.org/the-florida-bar-journal/defining-the-hourglass-when-is-a-claim-under-the-florida-civil-rights-act-time-barred/

Disclaimer: This template is provided for informational purposes only and does not constitute legal advice. An attorney licensed in Florida must review and customize this Charge before filing. The 365-day FCRA filing window under Fla. Stat. § 760.11(1) is jurisdictional; missing it forfeits the FCRA claim. Verify all authorities and deadlines before submission.