Indiana Civil Rights Commission (ICRC) Charge of Discrimination

CHARGE OF DISCRIMINATION — INDIANA CIVIL RIGHTS COMMISSION

TABLE OF CONTENTS

1. Charge Header and Agency Information
2. Charging Party (Complainant) Information
3. Respondent (Employer / Provider) Information
4. Cause of Discrimination
5. Date(s) of Discrimination
6. Particulars / Statement of Facts
7. Relief Sought
8. Dual-Filing and Worksharing
9. Verification and Signature
10. Cover Letter to ICRC (Optional)
11. Indiana Practice Notes
12. Sources and References

1. CHARGE HEADER AND AGENCY INFORMATION

INDIANA CIVIL RIGHTS COMMISSION

Indiana Government Center North

100 N. Senate Avenue, Room N300

Indianapolis, IN 46204-2211

Telephone: (317) 232-2600 | Toll-Free: (800) 628-2909

Website: https://www.in.gov/icrc/

ICRC Charge No.: [ASSIGNED BY AGENCY — leave blank at filing]

EEOC Charge No.: [ASSIGNED BY AGENCY — leave blank at filing]

Date Charge Received: [__/__/____]

Type of Charge: ☐ Employment ☐ Housing ☐ Public Accommodations ☐ Education ☐ Credit

2. CHARGING PARTY (COMPLAINANT) INFORMATION

Authorized Representative (if any):

3. RESPONDENT (EMPLOYER / PROVIDER) INFORMATION

Individual(s) Involved (decision-makers, harassers, or witnesses):

4. CAUSE OF DISCRIMINATION

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

☐ Race — specify: [___________________________]

☐ Color

☐ Religion / Creed — specify: [___________________________]

☐ Sex (including pregnancy, childbirth, related medical conditions)

☐ Sexual Orientation [Note: covered federally under Title VII per Bostock; not enumerated under Indiana state civil rights law]

☐ Gender Identity [Note: covered federally under Title VII per Bostock; not enumerated under Indiana state civil rights law]

☐ National Origin — specify: [___________________________]

☐ Ancestry

☐ Disability (physical or mental) — specify: [___________________________]

☐ Age (40–75) [Indiana coverage under IC 22-9-2; federal coverage under ADEA]

☐ Genetic Information [GINA — federal only]

☐ Veteran / Military Status [USERRA — federal only]

☐ Retaliation for protected activity (opposition, filing, participation)

☐ Familial Status [Housing only]

☐ Other: [_______________]

5. DATE(S) OF DISCRIMINATION

6. PARTICULARS / STATEMENT OF FACTS

I. PERSONAL BACKGROUND. I am [a member of the protected class(es) checked above — describe specifically]. I was hired by Respondent on or about [__/__/____] as a [POSITION TITLE]. My most recent rate of pay was [$____ per hour / $____ annually], and I worked at Respondent's [LOCATION] facility under the supervision of [SUPERVISOR NAME, TITLE].

II. QUALIFICATIONS AND PERFORMANCE. Throughout my employment, I performed my duties competently and met or exceeded Respondent's legitimate expectations. My performance reviews were [SATISFACTORY / EXCELLENT / RATINGS], and I had no documented disciplinary issues prior to the events described below.

III. SPECIFIC DISCRIMINATORY ACTS.

A. On or about [__/__/____], [NAME / TITLE OF DECISION-MAKER] [DESCRIBE FIRST INCIDENT — what was said or done, who was present, the circumstances].

B. On or about [__/__/____], [DESCRIBE SECOND INCIDENT].

C. On or about [__/__/____], [DESCRIBE THIRD INCIDENT].

D. On or about [__/__/____], I was [TERMINATED / DEMOTED / DENIED PROMOTION / DENIED ACCOMMODATION / SUBJECTED TO ADVERSE ACTION]. The reason given by Respondent was [STATED REASON].

IV. COMPARATIVE TREATMENT. Similarly situated employees outside my protected class were treated more favorably. Specifically:

• [NAME / TITLE], who is [OUTSIDE THE PROTECTED CLASS], received [FAVORABLE TREATMENT — promotion, pay raise, lighter discipline, accommodation] under similar circumstances.
• [NAME / TITLE], who is [OUTSIDE THE PROTECTED CLASS], [ADDITIONAL COMPARISON].

V. PROTECTED ACTIVITY (if retaliation is alleged). On or about [__/__/____], I engaged in protected activity by [REPORTING DISCRIMINATION TO HR / FILING INTERNAL COMPLAINT / FILING PRIOR EEOC OR ICRC CHARGE / OPPOSING UNLAWFUL CONDUCT / REQUESTING ACCOMMODATION]. Within [TIMEFRAME] thereafter, Respondent [DESCRIBE RETALIATORY ACT].

VI. EVIDENCE OF PRETEXT / DISCRIMINATORY ANIMUS. Respondent's stated reason for the adverse action is false because:

• [Inconsistent or shifting explanations];
• [Departure from established policy or practice];
• [Direct evidence — quoted statements, emails, text messages];
• [Statistical or pattern evidence, if known];
• [Temporal proximity to protected activity].

VII. HARM SUFFERED. As a result of Respondent's conduct, I have suffered:

• Loss of wages, benefits, and seniority;
• Out-of-pocket expenses, including [ITEMIZE];
• Emotional distress, including [SLEEP DISTURBANCE / ANXIETY / DEPRESSION / MEDICAL TREATMENT];
• Damage to my professional reputation;
• [OTHER].

VIII. STATEMENT OF DISCRIMINATION. I believe I have been discriminated against on the basis of [PROTECTED CLASS(ES)] in violation of Title VII of the Civil Rights Act of 1964, [42 U.S.C. § 1981 / the Americans with Disabilities Act / the Age Discrimination in Employment Act / the Pregnancy Discrimination Act], and the Indiana Civil Rights Law, Ind. Code § 22-9-1 et seq.

7. RELIEF SOUGHT

I respectfully request that the Indiana Civil Rights Commission investigate this charge and grant the following relief:

• ☐ A finding of probable cause that Respondent engaged in unlawful discrimination;
• ☐ Reinstatement to my former position with full seniority and benefits;
• ☐ Back pay and lost benefits, with interest;
• ☐ Front pay in lieu of reinstatement, where appropriate;
• ☐ Compensatory damages for emotional distress and other harm (federal claims);
• ☐ Punitive damages (federal claims);
• ☐ A cease-and-desist order under Ind. Code § 22-9-1-6;
• ☐ Affirmative relief, including policy changes, training, and posting of notices;
• ☐ Expungement of adverse personnel records and a neutral letter of reference;
• ☐ Reasonable attorney's fees and costs;
• ☐ Conciliation / mediation through the ICRC's voluntary process;
• ☐ Such other relief as the Commission deems appropriate.

8. DUAL-FILING AND WORKSHARING

I want this charge dual-filed with both the Indiana Civil Rights Commission and the U.S. Equal Employment Opportunity Commission ("EEOC") pursuant to the existing ICRC/EEOC work-share agreement. ☐ Yes ☐ No

I understand that:

• The 180-day deadline applies for ICRC processing under Indiana law (Ind. Code § 22-9-1-3); the 300-day deadline applies for EEOC processing under federal law (42 U.S.C. § 2000e-5(e)(1)).
• The ICRC may transfer this matter to a local human rights commission with concurrent jurisdiction (e.g., Indianapolis, Bloomington, South Bend, Evansville, Lafayette) pursuant to Ind. Code § 22-9-1-12.1.
• I have a continuing duty to update the ICRC and EEOC of any change of address, telephone, or email.
• I am required to cooperate in the investigation and provide additional information when requested.

9. VERIFICATION AND SIGNATURE

I declare under penalty of perjury that the foregoing is true and correct to the best of my knowledge, information, and belief. I further authorize the Indiana Civil Rights Commission and the EEOC to investigate this charge and to share relevant information with each other and with any local human rights agency that may have concurrent jurisdiction.

Date: [__/__/____]

[________________________________]

[CHARGING PARTY NAME]

STATE OF INDIANA

COUNTY OF [COUNTY]

Sworn to and subscribed before me this [____] day of [_______________], 20[____].

[________________________________]

Notary Public

My Commission Expires: [_______________]

Residing in [_______________] County, Indiana

10. COVER LETTER TO ICRC (OPTIONAL)

[__/__/____]

Indiana Civil Rights Commission

Intake Unit

100 N. Senate Avenue, Room N300

Indianapolis, IN 46204-2211

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

Dear Intake Officer:

Enclosed please find the verified Charge of Discrimination of [CHARGING PARTY NAME] against [RESPONDENT NAME], alleging unlawful discrimination on the basis of [PROTECTED CLASS(ES)] in violation of the Indiana Civil Rights Law, Ind. Code § 22-9-1 et seq., and Title VII of the Civil Rights Act of 1964 (and [other federal statutes as applicable]). The charge is timely filed within 180 days of the most recent discriminatory act under Ind. Code § 22-9-1-3.

Please dual-file this charge with the EEOC pursuant to the existing work-sharing agreement, and please confirm receipt and assignment of an ICRC and EEOC charge number.

The following documents are enclosed in support of the charge:

• ☐ Signed and verified Charge of Discrimination
• ☐ Copy of relevant employment records (offer letter, performance reviews, disciplinary records)
• ☐ Copy of internal complaint(s) and HR correspondence
• ☐ Copies of relevant emails, text messages, and witness statements
• ☐ Medical documentation (if disability is at issue) — please treat as confidential
• ☐ Notice of Appearance of Counsel (if applicable)
• ☐ Privacy waiver / HIPAA authorization (if applicable)

I respectfully request that the Commission promptly investigate this charge, consider the relief requested in Section 7, and offer the parties an opportunity for voluntary mediation.

Please direct all correspondence to the undersigned.

Respectfully,

[________________________________]

[CHARGING PARTY NAME] [OR ATTORNEY NAME]

[ADDRESS / TELEPHONE / EMAIL]

Enclosures

11. INDIANA PRACTICE NOTES

• Filing as exhaustion. Filing this charge with the ICRC is generally a precondition to any subsequent court action based on the Indiana Civil Rights Law. Indiana state law does not provide a general private right of action in court for damages under IC 22-9-1; the ICRC's administrative process is the default forum, and court adjudication requires a probable-cause determination plus written election by both parties under IC 22-9-1-16. By contrast, federal Title VII / ADA / ADEA claims become court-enforceable upon issuance of an EEOC right-to-sue letter, with a 90-day filing window thereafter.
• 180-day vs. 300-day. The ICRC's own deadline is 180 days (IC 22-9-1-3). Because Indiana is a deferral state with a FEPA, the EEOC deadline is 300 days. Filing with one agency dual-files with the other under their work-share agreement, but to preserve state-law remedies, file within 180 days.
• Continuing violations. Hostile work environment claims may reach back beyond 180/300 days if at least one act contributing to the environment occurred within the limitations window. Nat'l R.R. Passenger Corp. v. Morgan, 536 U.S. 101 (2002). Discrete adverse acts (termination, demotion, refusal to hire) require their own timely charge.
• Local commissions. Under IC 22-9-1-12.1, certain Indiana cities and counties have human rights ordinances and commissions with concurrent jurisdiction (e.g., Indianapolis-Marion County, Bloomington, South Bend, Lafayette, Evansville, Fort Wayne). These local ordinances often include sexual orientation and gender identity as protected classes, which the state statute does not. A complainant may file with the local commission, the ICRC, or both; transfers and exclusive jurisdiction are governed by IC 22-9-1-12.1.
• Mediation. ICRC offers free, voluntary mediation. Election does not waive a complainant's right to a formal investigation if mediation does not resolve the matter.
• Probable cause / no probable cause. After investigation, the ICRC issues a finding. A "no probable cause" finding may be appealed administratively. A "probable cause" finding triggers conciliation; if conciliation fails, the matter proceeds to an administrative hearing before an ALJ unless both parties elect court adjudication under IC 22-9-1-16.
• Cease-and-desist remedies. Under IC 22-9-1-6, the ICRC may order cease-and-desist, reinstatement, back pay, and other equitable relief. The ICRC does not award compensatory or punitive damages; those require federal court (Title VII / § 1981 / ADA) or — rarely — a state court action under IC 22-9-1-16 with both parties' written consent.
• Disability claims under IC 22-9-5. The Indiana Disability Discrimination Law mirrors the ADA and is administered by the ICRC. Some courts have read IC 22-9-5 as providing a more permissive private right of action than IC 22-9-1, but plaintiffs should still file the ICRC charge first.
• Pregnancy. IC 22-9-9 (the Indiana Pregnancy Accommodation statute, effective July 1, 2025) requires employers of 15+ to discuss reasonable accommodations. ICRC investigates these complaints under the same charge process.
• Public-sector / governmental respondents. A charge against a state or local governmental unit may also implicate constitutional claims under 42 U.S.C. § 1983 (cognizable directly in court without ICRC exhaustion). The Indiana Tort Claims Act notice requirement (IC 34-13-3-8) does not apply to federal civil rights claims but may apply to ancillary state-law tort claims.
• Retaliation post-filing. Filing the charge is itself protected activity. If retaliation occurs after filing, file an amended or supplemental charge promptly.

12. SOURCES AND REFERENCES

• Indiana Civil Rights Commission (homepage) — https://www.in.gov/icrc/
• ICRC: How to File a Discrimination Complaint — https://www.in.gov/icrc/file-a-discrimination-complaint/how-to-file/
• ICRC: Enforcement and Process — https://www.in.gov/icrc/file-a-discrimination-complaint/enforcement/
• ICRC: Indiana Civil Rights Laws & Regulations — https://www.in.gov/icrc/about-icrc/indiana-civil-rights-laws-and-regulations/
• ICRC PDF — Chapter 1 (IC 22-9-1) — https://www.in.gov/icrc/files/Chapter_1.pdf
• Indiana General Assembly — Title 22, Article 9 — https://iga.in.gov/laws/2024/ic/titles/22/#22-9
• Ind. Code § 22-9-1-3 — https://iga.in.gov/laws/2024/ic/titles/22#22-9-1-3
• Ind. Code § 22-9-1-6 — https://iga.in.gov/laws/2024/ic/titles/22#22-9-1-6
• Ind. Code § 22-9-1-16 — https://iga.in.gov/laws/2024/ic/titles/22#22-9-1-16
• 910 IAC (ICRC Administrative Rules) — https://iac.iga.in.gov/iac//title910.html
• EEOC Fair Employment Practices Agencies (FEPAs) and Dual Filing — https://www.eeoc.gov/fair-employment-practices-agencies-fepas-and-dual-filing
• EEOC Charge Procedures — https://www.eeoc.gov/filing-charge-discrimination
• Title VII (42 U.S.C. § 2000e et seq.) — https://www.eeoc.gov/statutes/title-vii-civil-rights-act-1964
• Bostock v. Clayton County, 590 U.S. 644 (2020) — sexual orientation/gender identity under Title VII
• Nat'l R.R. Passenger Corp. v. Morgan, 536 U.S. 101 (2002) — continuing violation
• Fort Bend County v. Davis, 587 U.S. 541 (2019) — exhaustion as claim-processing rule
• McKinney School of Law, The Effect of Indiana Code Section 22-9-1-16 on Employee Civil Rights — https://mckinneylaw.iu.edu/practice/law-reviews/ilr/pdf/vol42p441.pdf

Disclaimer: This template is provided for informational purposes only and does not constitute legal advice. An attorney licensed in Indiana must review and customize this document before filing. Filing deadlines under Indiana civil rights law are short and strictly enforced — late charges will be dismissed. Indiana state civil rights law does not generally provide a private right of action for damages in court, and exhaustion before the ICRC is a precondition to most state-law remedies. Verify all statutes, rules, and addresses at iga.in.gov, in.gov/icrc, and eeoc.gov before filing.