Georgia Human Rights Agency Charge — GCEO / EEOC

GEORGIA HUMAN RIGHTS AGENCY CHARGE OF DISCRIMINATION

TABLE OF CONTENTS

1. Agency Selection and Filing Information
2. Charging Party Information
3. Respondent (Employer) Information
4. Cause of Discrimination
5. Date(s) of Discrimination
6. Statement of Particulars (Narrative)
7. Continuing Violation / Hostile Work Environment
8. Comparators and Evidence of Discriminatory Treatment
9. Retaliation Allegations
10. Reasonable Accommodation Allegations
11. Damages and Relief Requested
12. Witnesses
13. Verification and Signature
14. Worksharing / Dual-Filing Authorization
15. Filing and Submission Checklist
16. Georgia Practice Notes
17. Sources and References

1. AGENCY SELECTION AND FILING INFORMATION

☐ GEORGIA COMMISSION ON EQUAL OPPORTUNITY (GCEO) — Equal Employment Division

• Address: 205 Jesse Hill Jr. Drive SE, 14th Floor, Suite 1470B, East Tower, Atlanta, GA 30334
• Phone: (404) 656-1736 | Toll-Free: (800) 473-6736
• Website: https://gceo.georgia.gov/
• Required when Respondent is the State of Georgia or a state agency and the Charging Party is a state employee or applicant.

☐ U.S. EQUAL EMPLOYMENT OPPORTUNITY COMMISSION (EEOC) — Atlanta District Office

• Address: 100 Alabama Street, SW, Suite 4R30, Atlanta, GA 30303
• Phone: (404) 562-6800 | TTY: (404) 562-6801
• Website: https://www.eeoc.gov/field-office/atlanta
• Required (or recommended) for all private-sector, county, municipal, and school-district Respondents. Georgia is a non-deferral state — 180-day window applies.

Agency Charge Number (assigned by agency): [________________________________]

Date Filed: [__/__/____]

Filing Method: ☐ EEOC Public Portal | ☐ GCEO Online Questionnaire | ☐ In-Person | ☐ U.S. Mail (certified, return receipt requested) | ☐ Email

2. CHARGING PARTY INFORMATION

3. RESPONDENT (EMPLOYER) INFORMATION

4. CAUSE OF DISCRIMINATION

☐ Race — specify: [____]
☐ Color — specify: [____]
☐ Religion — specify: [____]
☐ Sex (including pregnancy, sexual orientation, and gender identity per Bostock v. Clayton County, 590 U.S. 644 (2020))
☐ National Origin — specify: [____]
☐ Age — date of birth [__/__/____] (must be 40 or older)
☐ Disability — specify diagnosis or impairment: [____]
☐ Genetic Information (GINA, 42 U.S.C. § 2000ff)
☐ Retaliation for protected activity: [____]
☐ Failure to Provide Reasonable Accommodation (ADA / Title VII religious / O.C.G.A. § 34-6A)
☐ Other (specify): [____]

Statute(s) invoked:

☐ Title VII of the Civil Rights Act of 1964, 42 U.S.C. § 2000e et seq.
☐ Age Discrimination in Employment Act (ADEA), 29 U.S.C. § 621 et seq.
☐ Americans with Disabilities Act (ADA), 42 U.S.C. § 12101 et seq.
☐ Equal Pay Act, 29 U.S.C. § 206(d)
☐ Genetic Information Nondiscrimination Act (GINA), 42 U.S.C. § 2000ff
☐ Pregnant Workers Fairness Act (PWFA), 42 U.S.C. § 2000gg
☐ Georgia FEPA, O.C.G.A. § 45-19-20 et seq. (state employees only)
☐ Georgia Equal Employment for Persons with Disabilities Code, O.C.G.A. § 34-6A-1 et seq.
☐ Georgia Age Discrimination Statute, O.C.G.A. § 34-1-2

5. DATE(S) OF DISCRIMINATION

6. STATEMENT OF PARTICULARS (NARRATIVE)

I, [CHARGING PARTY NAME], allege the following facts in support of this Charge:

A. Employment Background.

I was hired by Respondent on [__/__/____] as a [POSITION]. At all relevant times I was qualified for my position and performed my duties satisfactorily, as reflected in my [performance reviews / commendations / promotions / pay increases].

B. Protected-Class Membership.

I am a member of the following protected class(es): [describe — e.g., African American; female; age 52 (DOB __/__/____); individual with diabetes requiring reasonable accommodation; etc.].

C. Discriminatory Conduct.

Beginning on or about [__/__/____], Respondent engaged in the following discriminatory conduct:

1. [Describe first incident with date, actors, witnesses, and conduct.]
2. [Describe second incident.]
3. [Continue numbered narrative — be specific. Identify decision-makers by name and title.]

D. Adverse Action.

On [__/__/____], Respondent [terminated my employment / demoted me / suspended me without pay / failed to promote me / failed to hire me / constructively discharged me / subjected me to a hostile work environment]. The stated reason was [employer's stated reason], which is pretextual because [explain why the stated reason is false or insufficient].

E. Causal Link.

I believe the adverse action was because of my [protected class] for the following reasons: [summarize direct or circumstantial evidence — supervisor statements, comparator treatment, statistical disparities, shifting explanations, temporal proximity, etc.].

7. CONTINUING VIOLATION / HOSTILE WORK ENVIRONMENT

☐ I allege a continuing pattern of harassment or hostile work environment based on [protected class]. The most recent act contributing to the hostile environment occurred on [__/__/____].

The harassment was sufficiently severe or pervasive to alter the conditions of my employment because:

• [Frequency — e.g., near-daily comments]
• [Severity — e.g., physical threats, slurs, sexual touching]
• [Whether it interfered with work performance]
• [Whether supervisors participated or knew and failed to act]

I reported the harassment to [NAME, TITLE] on [__/__/____] and Respondent [failed to take prompt remedial action / retaliated against me / told me there was nothing they could do].

8. COMPARATORS AND EVIDENCE OF DISCRIMINATORY TREATMENT

Direct evidence of discriminatory animus: [Quote any statements by decision-makers reflecting bias — e.g., "We need someone younger," "Women can't handle this job," etc.]

9. RETALIATION ALLEGATIONS

☐ I also allege retaliation. I engaged in the following protected activity:

• [Date and description — e.g., filed internal EEO complaint; opposed harassment; requested accommodation; filed prior EEOC charge no. ___]

Within [NUMBER] days of that protected activity, Respondent took the following materially adverse action against me: [describe]. The temporal proximity and [other circumstantial evidence] establish a causal link.

10. REASONABLE ACCOMMODATION ALLEGATIONS

☐ I requested a reasonable accommodation on [__/__/____]. The accommodation requested was: [describe — e.g., modified schedule, ergonomic equipment, leave for medical treatment, prayer break, lactation accommodation, light-duty assignment].

Respondent's response: [describe — e.g., refused to engage in the interactive process; denied without explanation; granted accommodation but later revoked it; terminated me in lieu of accommodating].

Supporting medical / religious documentation: ☐ Provided to Respondent on [__/__/____] | ☐ Available upon request | ☐ Not yet provided

11. DAMAGES AND RELIEF REQUESTED

I have suffered the following injuries:

I request the following relief:

☐ Reinstatement to my prior position with full seniority and benefits
☐ Back pay with interest
☐ Front pay in lieu of reinstatement
☐ Compensatory damages
☐ Punitive damages (Title VII / ADA / § 1981)
☐ Liquidated damages (ADEA willful violation)
☐ Removal of negative information from personnel file
☐ Neutral letter of reference
☐ Posting of EEO notice
☐ Mandatory anti-discrimination training for Respondent's managers
☐ Reasonable accommodation: [describe]
☐ Attorneys' fees and costs
☐ Such other relief as the agency deems appropriate

12. WITNESSES

13. VERIFICATION AND SIGNATURE

I declare under penalty of perjury under the laws of the United States and the State of Georgia that the foregoing is true and correct to the best of my knowledge.

Date: [__/__/____]

Charging Party Signature: [________________________________]

Printed Name: [________________________________]

NOTARIZATION (required by GCEO; strongly recommended for EEOC)

STATE OF GEORGIA

COUNTY OF [COUNTY]

Sworn to and subscribed before me this [____] day of [_______________], 20[____], by [CHARGING PARTY NAME], who is personally known to me or who produced [IDENTIFICATION] as identification.

[________________________________]

Notary Public

(My Commission Expires: [_______________])

14. WORKSHARING / DUAL-FILING AUTHORIZATION

I authorize the receiving agency to dual-file this Charge with the other agency under their worksharing agreement (if applicable):

☐ I authorize GCEO to transmit a copy of this Charge to the EEOC for dual filing under 29 C.F.R. § 1601.13.

☐ I authorize the EEOC to transmit a copy of this Charge to GCEO if jurisdiction lies there.

☐ I do NOT authorize dual filing.

Signature: [________________________________]

15. FILING AND SUBMISSION CHECKLIST

☐ Confirm 180-day deadline has not expired (calculate from latest discriminatory act).
☐ Confirm correct agency: GCEO (state employer only) or EEOC (everyone else).
☐ Complete all fields, including respondent legal name and worksite address.
☐ Mark every applicable basis in Section 4.
☐ Attach supporting documents:
☐ Termination letter / disciplinary notice
☐ Performance evaluations
☐ Pay stubs / W-2
☐ Internal complaints and Respondent's responses
☐ Medical / religious accommodation documentation
☐ Comparator-treatment evidence
☐ Witness contact list
☐ Sign and notarize the verification.
☐ Retain a complete copy of the Charge and all attachments.
☐ Submit via [EEOC Public Portal — https://publicportal.eeoc.gov/ / GCEO online questionnaire / certified mail, return receipt requested / in person].
☐ Calendar follow-up dates: 30-day check-in; 180-day right-to-sue eligibility (Title VII); 60-day ADEA suit eligibility.

16. GEORGIA PRACTICE NOTES

• Non-deferral state, 180 days. Georgia has no state Fair Employment Practices Agency that covers private-sector employers. The EEOC charge-filing deadline is 180 days, not 300. 42 U.S.C. § 2000e-5(e)(1). Calculate the deadline conservatively from the earliest plausible accrual date.
• GCEO jurisdiction is limited to state employers. GCEO will reject charges against private employers, counties, municipalities, and school districts at intake. Filing with GCEO does not toll the EEOC deadline for those Respondents. Always file directly with EEOC for non-state employers.
• GCEO process. Under O.C.G.A. § 45-19-36, the charge must be in writing, under oath or affirmation, and contain a statement of facts. GCEO conducts a jurisdictional review, intake interview, investigation, conciliation, and determination. A complainant who exhausts GCEO process may sue under O.C.G.A. § 45-19-39 within the time prescribed.
• EEOC process. After filing, EEOC may dismiss, mediate, investigate, or issue a Notice of Right to Sue. For Title VII, ADA, GINA, and PWFA charges, the Charging Party may request a right-to-sue letter at any time after 180 days. For ADEA, the Charging Party may sue 60 days after filing without a right-to-sue letter.
• Statute-specific tolling. Filing a charge tolls the limitations period for Title VII, ADEA, and ADA claims but does not toll the 4-year limitations period for § 1981 race-discrimination claims (which require no exhaustion). For the Georgia Equal Employment for Persons with Disabilities Code, suit must be filed within 180 days under O.C.G.A. § 34-6A-6 — agency exhaustion is not required and does not extend the deadline.
• Continuing violations. National R.R. Passenger Corp. v. Morgan, 536 U.S. 101 (2002), permits hostile-work-environment claims to reach back beyond 180 days if any contributing act fell within the window, but discrete acts (terminations, denials of promotion) must each be independently timely.
• Pregnancy and PWFA. As of 2026, pregnancy-accommodation claims are pleaded under both Title VII (PDA) and the federal Pregnant Workers Fairness Act, 42 U.S.C. § 2000gg. Georgia has no parallel state pregnancy-accommodation statute.
• Sexual orientation and gender identity. Bostock v. Clayton County, 590 U.S. 644 (2020), a Georgia case, confirms Title VII covers sexual orientation and gender identity. Georgia state law does not separately prohibit such discrimination.
• Retaliation is independently actionable. Even if the underlying discrimination claim fails, a retaliation claim survives if Charging Party engaged in protected activity in a reasonable, good-faith belief that the conduct was unlawful.
• Public-sector charges. For county or municipal employers, file with EEOC. For state employers, file with GCEO and consider parallel EEOC filing through worksharing.
• Preservation of records. Charging Party should preserve all employment records, electronic communications, social-media messages, and personnel files. Once a charge is filed, Respondent has a duty to preserve records under 29 C.F.R. § 1602.

17. SOURCES AND REFERENCES

• Georgia Commission on Equal Opportunity (GCEO): https://gceo.georgia.gov/
• GCEO Equal Employment Division: https://gceo.georgia.gov/equal-employment-division
• GCEO FAQs: https://gceo.georgia.gov/faqs
• GCEO Employment Complaint Questionnaire: https://gceo.georgia.gov/complaints/employment-complaint-questionnaire
• O.C.G.A. § 45-19-29 (Unlawful Practices): https://law.justia.com/codes/georgia/title-45/chapter-19/article-2/section-45-19-29/
• O.C.G.A. § 45-19-36 (Charge filing; 180 days)
• O.C.G.A. § 34-1-2 (Age): https://law.justia.com/codes/georgia/title-34/chapter-1/section-34-1-2/
• O.C.G.A. Title 34, Chapter 6A (Disability): https://law.justia.com/codes/georgia/title-34/chapter-6a/
• EEOC Atlanta District Office, 100 Alabama Street, SW, Suite 4R30, Atlanta, GA 30303; (404) 562-6800: https://www.eeoc.gov/field-office/atlanta
• EEOC Public Portal: https://publicportal.eeoc.gov/
• 29 C.F.R. § 1601.13 (Worksharing agreements)
• National R.R. Passenger Corp. v. Morgan, 536 U.S. 101 (2002)
• Bostock v. Clayton County, 590 U.S. 644 (2020)
• McDonnell Douglas Corp. v. Green, 411 U.S. 792 (1973)
• Ga. Comp. R. & Regs. r. 186-1: https://rules.sos.ga.gov/gac/186-1

Disclaimer: This template is provided for informational purposes only and does not constitute legal advice. Georgia is a non-deferral state with a strict 180-day charge-filing deadline. Filing with the wrong agency can waste the limitations period. Consult a Georgia-licensed employment attorney before filing.