Kentucky Commission on Human Rights (KCHR) Administrative Charge

CHARGE OF DISCRIMINATION — KENTUCKY COMMISSION ON HUMAN RIGHTS

Submitted to: Kentucky Commission on Human Rights (KCHR), 332 West Broadway, Suite 1400, Louisville, KY 40202 — (502) 595-4024 — kchr.ky.gov

Cross-Filed with: U.S. Equal Employment Opportunity Commission (EEOC) Louisville Area Office under the KCHR/EEOC Worksharing Agreement

TABLE OF CONTENTS

1. Charge Information
2. Complainant
3. Respondent
4. Bases of Discrimination Alleged
5. Statutes Invoked
6. Dates of Discriminatory Acts and Timeliness
7. Statement of Particulars
8. Damages and Relief Requested
9. Cross-Filing and Dual-Filing Requests
10. Election of Remedies Acknowledgment
11. Verification Under Oath
12. Attachments
13. Counsel of Record
14. Kentucky Practice Notes
15. Sources and References

1. CHARGE INFORMATION

2. COMPLAINANT

Name: [________________________________]

Street Address: [________________________________]

City, State, ZIP: [________________________________]

Telephone (day): [________________] Telephone (cell): [________________]

Email: [________________________________]

Date of Birth (for age claims): [__/__/____]

County of Residence: [________________]

3. RESPONDENT

Name of Employer / Housing Provider / Public Accommodation: [________________________________]

Type of Entity: ☐ Corporation ☐ LLC ☐ Partnership ☐ Sole Proprietor ☐ Government Entity ☐ Other: [________________]

Street Address: [________________________________]

City, State, ZIP: [________________________________]

Telephone: [________________]

Number of Employees (for employment claims): ☐ 1-7 ☐ 8-14 ☐ 15-100 ☐ 101-200 ☐ 201-500 ☐ 500+

Individual Decisionmaker(s) / Aiders and Abettors (KRS 344.080):

4. BASES OF DISCRIMINATION ALLEGED

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

• ☐ Race: [________________]
• ☐ Color: [________________]
• ☐ Religion: [________________]
• ☐ National Origin / Ancestry: [________________]
• ☐ Sex (including pregnancy and sex stereotyping): [________________]
• ☐ Age (40 and over): [date of birth ___/___/_____ ]
• ☐ Disability (including failure to accommodate): [describe condition]
• ☐ Smoker / Nonsmoker Status: [________________]
• ☐ HIV/AIDS Status (KRS 207.135): [________________]
• ☐ Retaliation for protected activity (KRS 344.280): [describe protected activity]
• ☐ Familial Status (housing only): [________________]
• ☐ Sexual Orientation (LOCAL ORDINANCE only — list jurisdiction): [________________]
• ☐ Gender Identity / Gender Expression (LOCAL ORDINANCE only — list jurisdiction): [________________]

5. STATUTES INVOKED

This Charge is filed under and invokes the following statutes:

• ☐ Kentucky Civil Rights Act (KCRA), KRS Chapter 344 — including KRS 344.040 (employment), KRS 344.080 (aiding/abetting), KRS 344.120 (public accommodation), KRS 344.280 (retaliation), and/or KRS 344.360 (housing).
• ☐ Title VII of the Civil Rights Act of 1964, 42 U.S.C. § 2000e et seq. (cross-filed with EEOC).
• ☐ Americans with Disabilities Act, 42 U.S.C. § 12101 et seq. (cross-filed with EEOC).
• ☐ Age Discrimination in Employment Act, 29 U.S.C. § 621 et seq. (cross-filed with EEOC).
• ☐ Pregnancy Discrimination Act, 42 U.S.C. § 2000e(k).
• ☐ Pregnant Workers Fairness Act, 42 U.S.C. § 2000gg et seq.
• ☐ PUMP Act / Section 7(r) of the FLSA.
• ☐ Genetic Information Nondiscrimination Act (GINA), 42 U.S.C. § 2000ff et seq.
• ☐ Fair Housing Act, 42 U.S.C. § 3601 et seq. (cross-filed with HUD).
• ☐ Local Fairness Ordinance: [CITY/COUNTY AND CITATION].

6. DATES OF DISCRIMINATORY ACTS AND TIMELINESS

This Charge is timely because:

• ☐ It was filed within 180 days of the most recent discriminatory act, as required by KRS 344.200(1) for state-only filing.
• ☐ It is dual-filed with EEOC and accordingly is timely within 300 days of the most recent discriminatory act under 42 U.S.C. § 2000e-5(e)(1).
• ☐ The conduct is a continuing violation under National Railroad Passenger Corp. v. Morgan, 536 U.S. 101 (2002), with at least one act falling within the limitations window.
• ☐ Housing claim filed within 1 year under KRS 344.625(2) and 42 U.S.C. § 3610(a)(1)(A)(ii).

7. STATEMENT OF PARTICULARS

I, [COMPLAINANT NAME], hereby state and allege as follows:

7.1. Employment / Tenancy / Patron Background. I was hired by Respondent on or about [__/__/____] as a [POSITION / ROLE] at Respondent's facility located at [ADDRESS] in [CITY], [COUNTY] County, Kentucky. [For housing: I have been a tenant at __________ since __/__/____. For public accommodation: On __/__/____ I attempted to obtain goods/services at __________.]

7.2. Protected Status. At all relevant times, I am a member of one or more classes protected by the KCRA: [describe — e.g., African-American (race), female (sex), age 56 (age 40+), individual with disability of (condition), Muslim (religion), Hispanic (national origin), nonsmoker].

7.3. Qualifications / Standing. I was qualified for the position and performing my duties competently, as reflected in [performance reviews / commendations / metrics / customer feedback]. [For housing/public accommodation: I met all eligibility / payment / conduct requirements.]

7.4. Discriminatory Acts. Beginning on or about [__/__/____], Respondent and its agents subjected me to the following adverse actions because of my protected status:

• (a) [Description of incident #1 — date, actor, conduct, witnesses];
• (b) [Description of incident #2 — date, actor, conduct, witnesses];
• (c) [Description of incident #3 — date, actor, conduct, witnesses];
• (d) [Description of incident #4 — date, actor, conduct, witnesses].

7.5. Comparators / Disparate Treatment. Similarly situated individuals outside my protected class were treated more favorably, in that [describe comparators by initials, position, treatment].

7.6. Direct Evidence. [Describe any direct evidence of discriminatory animus, including verbatim slurs, written communications, policies, statistics, or admissions, with dates and witnesses.]

7.7. Internal Complaint. On or about [__/__/____], I complained to [HR / supervisor / manager] about the discriminatory conduct. Respondent [failed to investigate / took no remedial action / retaliated against me].

7.8. Adverse Action / Outcome. On or about [__/__/____], Respondent [terminated my employment / demoted me / disciplined me / denied my reasonable accommodation request / refused to rent to me / refused service / evicted me / constructively discharged me]. The justification offered — [stated reason] — is pretextual.

7.9. Failure to Accommodate (if applicable). I requested a reasonable accommodation on [__/__/____], namely [describe accommodation], supported by medical documentation from [provider] dated [__/__/____]. Respondent [denied / ignored / failed to engage in the interactive process regarding] my request. Granting the accommodation would not have imposed an undue hardship.

7.10. Retaliation (if applicable). I engaged in protected activity by [opposing discrimination, complaining internally, filing this charge, participating in an investigation], and Respondent took materially adverse action against me [describe and date] that would dissuade a reasonable person from making or supporting a charge of discrimination.

7.11. Causation. Respondent's stated reasons are pretextual. The true reason for the adverse action is my protected status and/or my protected activity, as evidenced by [temporal proximity, direct evidence, comparators, shifting reasons, pattern of conduct, statistics].

7.12. Harm. As a direct and proximate result of Respondent's conduct, I have suffered lost wages and benefits, out-of-pocket expenses, emotional distress, humiliation, mental anguish, reputational harm, [medical / counseling expenses], and loss of enjoyment of life.

8. DAMAGES AND RELIEF REQUESTED

I request the following relief from KCHR pursuant to KRS 344.230:

• ☐ A. A finding that Respondent engaged in unlawful [employment / housing / public accommodation] discrimination in violation of KRS Chapter 344.
• ☐ B. A cease-and-desist order prohibiting further violations.
• ☐ C. Reinstatement / hiring / promotion / restoration of housing / restoration of public-accommodation access.
• ☐ D. Back pay with interest from the date of the unlawful act through the date of remedial order.
• ☐ E. Front pay where reinstatement is not feasible.
• ☐ F. Compensatory damages for emotional distress, humiliation, mental anguish, and other actual damages.
• ☐ G. Affirmative remedial actions, including written policies, anti-discrimination training, posting of notices, and reporting requirements.
• ☐ H. Attorney fees and costs under KRS 344.230(3)(h) (where applicable in a final order).
• ☐ I. Issuance of a Notice of Right to Sue at the appropriate stage to permit Complainant to pursue civil remedies under KRS 344.450.
• ☐ J. Such other relief as the Commission deems just and proper.

9. CROSS-FILING AND DUAL-FILING REQUESTS

Pursuant to the KCHR/EEOC Worksharing Agreement and the KCHR/HUD Worksharing Agreement (where applicable), I request that this Charge be:

• ☐ Cross-filed with the U.S. Equal Employment Opportunity Commission, Louisville Area Office (or its successor), 600 Dr. Martin Luther King Jr. Place, Suite 268, Louisville, KY 40202; (800) 669-4000.
• ☐ Cross-filed with the U.S. Department of Housing and Urban Development, Region IV, Atlanta Regional Office; (800) 669-9777.
• ☐ Cross-filed with the local Human Relations Commission of [Louisville Metro / Lexington-Fayette Urban County / Covington / Frankfort / Vicco / Midway / Danville / Paducah / Henderson / Morehead / Maysville / Bellevue / Dayton / Highland Heights / Newport / Versailles / Georgetown / Other: __________] under its Fairness Ordinance.
• ☐ I authorize KCHR to share documents and findings with the cross-filing agencies as permitted by the worksharing agreements.

10. ELECTION OF REMEDIES ACKNOWLEDGMENT

I understand that under KRS 344.270 and Vaezkoroni v. Domino's Pizza, 914 S.W.2d 341 (Ky. 1995), a final order of the Commission on the merits of this Charge may bar a subsequent civil action under KRS 344.450 on the same grievance. I therefore:

• ☐ Elect to pursue this Charge to a final order before the Commission.
• ☐ Reserve the right to withdraw this Charge prior to a final order in order to preserve the private right of action under KRS 344.450, and request that KCHR notify me before issuing any final order on the merits.
• ☐ Request a Notice of Right to Sue from EEOC after 180 days under 29 C.F.R. § 1601.28(a) so that I may pursue Title VII / ADA / ADEA civil remedies in court.

I understand that:

• (a) The KCRA does not require exhaustion of KCHR remedies before filing a private civil action under KRS 344.450 (Clifton v. Midway College, 702 S.W.2d 835 (Ky. 1985); Vaezkoroni, 914 S.W.2d 341).
• (b) Title VII / ADA / ADEA civil suits DO require EEOC exhaustion and a Notice of Right to Sue, and must be filed within 90 days of receipt of that Notice.
• (c) KCHR investigations may take 180 days or longer; conciliation, public hearing, and judicial review follow.

11. VERIFICATION UNDER OATH

COMMONWEALTH OF KENTUCKY

COUNTY OF [______________________], to-wit:

I, [COMPLAINANT NAME], being first duly sworn upon oath, depose and state that I am the Complainant in this Charge of Discrimination; that I have read the foregoing Charge; and that the allegations therein are true and correct to the best of my knowledge, information, and belief.

[________________________________]

[COMPLAINANT NAME]

Subscribed and sworn to before me by [COMPLAINANT NAME] this [____] day of [_______________], 20[____].

[________________________________]

Notary Public, State at Large, Kentucky

Notary ID No.: [________________]

My commission expires: [_______________]

12. ATTACHMENTS

The following documents are submitted in support of this Charge:

• ☐ Exhibit A — Personnel file or relevant excerpts (offer letter, performance reviews, disciplinary records, separation notice).
• ☐ Exhibit B — Employer policies (anti-discrimination, accommodation, complaint procedures, employee handbook).
• ☐ Exhibit C — Internal complaints, HR correspondence, and Respondent's responses.
• ☐ Exhibit D — Medical documentation supporting disability and accommodation request (HIPAA-authorized).
• ☐ Exhibit E — Pay records, W-2s, paystubs, and benefits statements (for back-pay calculation).
• ☐ Exhibit F — Comparator information (initials, role, treatment).
• ☐ Exhibit G — Communications (emails, texts, letters, social-media screenshots) reflecting discriminatory animus.
• ☐ Exhibit H — Witness list with contact information.
• ☐ Exhibit I — Lease, application, denial letter, or service-refusal documentation (housing / public accommodation).
• ☐ Exhibit J — Cross-filing forms (EEOC Form 5; HUD Form 903; local Fairness Ordinance complaint).
• ☐ Exhibit K — Mitigation evidence (job-search records, replacement income).

13. COUNSEL OF RECORD

Attorney Name: [________________________________]

Kentucky Bar Association No.: [________________]

Law Firm: [________________________________]

Street Address: [________________________________]

City, State, ZIP: [________________________________]

Telephone: [________________]

Facsimile: [________________]

Email: [________________________________]

By signing below, I acknowledge that I represent Complainant in connection with this Charge and authorize KCHR and EEOC (and any cross-filing agency) to direct all communications regarding this matter to me as counsel of record.

[________________________________]

[ATTORNEY NAME], Counsel for Complainant

Date: [__/__/____]

14. KENTUCKY PRACTICE NOTES

• 180 days vs. 300 days. State-only KCHR filings must be made within 180 days of the discriminatory act under KRS 344.200(1). Dual-filed charges (KCHR + EEOC under the Worksharing Agreement) extend the federal deadline to 300 days in Kentucky as a deferral state. Always check the dual-file box and plead the federal counts in the narrative to capture the longer period. Housing charges have a 1-year window (KRS 344.625(2); 42 U.S.C. § 3610(a)(1)(A)(ii)).

• Exhaustion is NOT required for a private civil action under KCRA. Clifton v. Midway College, 702 S.W.2d 835 (Ky. 1985); Vaezkoroni v. Domino's Pizza, 914 S.W.2d 341 (Ky. 1995). A Complainant who wishes to preserve the private right of action under KRS 344.450 should generally NOT pursue KCHR to a final merits order. Strategies: (a) skip KCHR entirely and file a five-year-SOL civil suit under KRS 413.120(2); or (b) file with KCHR for EEOC dual-filing benefit and withdraw before any merits order.

• Election of remedies — KRS 344.270. Once KCHR issues a final order on the merits (probable cause adjudicated, public hearing held, final order entered), the Complainant cannot bring a separate civil action on the same grievance. Wilson v. Lowe's Home Center, 75 S.W.3d 229 (Ky. App. 2001). Monitor the docket; if a probable-cause determination issues, evaluate immediately whether to request a Right-to-Sue or accept the administrative track to final order.

• EEOC dual-filing is automatic but specify it. Under the KCHR/EEOC Worksharing Agreement, charges filed with KCHR are deemed filed with EEOC (and vice versa). Always identify the cross-filing on the form and request a federal charge number to ensure proper docketing. If EEOC retains the charge, KCHR may close its file as "deferred to EEOC."

• Title VII vs. KCRA scope. Title VII includes sexual orientation and gender identity (post-Bostock v. Clayton County, 590 U.S. 644 (2020)); KCRA does not. For SO/GI claims, dual-file with EEOC under Title VII to capture coverage AND file locally where a Fairness Ordinance applies.

• Local Fairness Ordinances. Approximately two dozen Kentucky cities and counties prohibit discrimination based on sexual orientation and/or gender identity. Louisville Metro (LMCO Chapter 92), Lexington-Fayette Urban County (Code Chapter 2), Covington, Frankfort, Vicco, Midway, Danville, Paducah, Henderson, Morehead, Maysville, Bellevue, Dayton, Highland Heights, Newport, Versailles, Georgetown, and others have Human Relations / Human Rights Commissions that accept SO/GI complaints. Procedures and damages provisions vary; consult the specific ordinance.

• Investigator interviews. Once assigned, the KCHR investigator will request a fact-finding conference, position statements, and document production. Cooperate fully but coordinate all communications through counsel to avoid inconsistent statements that could become evidence in any later civil action.

• Conciliation. KCHR offers voluntary mediation early in the process. A mediated settlement is enforceable as a contract and typically includes a mutual release. Evaluate offers carefully — administrative settlements often include broad releases of state and federal claims.

• Public hearing under KRS 13B.080. If conciliation fails after a probable-cause determination, KCHR may convene a public hearing before a hearing officer. The Commission may award the relief listed in KRS 344.230, including reinstatement, back pay, compensatory damages, and affirmative action. Final orders are subject to judicial review under KRS 344.240 in Circuit Court within 30 days.

• Damages awardable by KCHR. KRS 344.230 authorizes back pay, reinstatement, hiring, promotion, cease-and-desist orders, affirmative action, and "such other and further action as in the judgment of the commission will effectuate the purposes of this chapter," including emotional-distress damages. KCHR cannot award attorney fees in most administrative proceedings — fees are recoverable in a KRS 344.450 civil action.

• Punitive damages — not available under KCRA. Kentucky Dep't of Corrections v. McCullough, 123 S.W.3d 130 (Ky. 2003). Plaintiffs seeking punitive damages must rely on parallel federal counts (Title VII / ADA / § 1981) or a wrongful-discharge-in-violation-of-public-policy tort.

• Statute of limitations on judicial review. Under KRS 344.240, judicial review of a KCHR final order must be filed in Circuit Court within 30 days of the order. Calendar this carefully — review is by petition, not by trial de novo.

• Witness preservation. At the intake stage, identify witnesses by name, role, and contact information. Witnesses may become unavailable during the 180-day-plus investigation; consider sworn declarations preserved through counsel.

• Confidentiality. KCHR investigations are confidential under KRS 61.878(1)(h) until probable-cause determination. Complainants should not disclose the pendency of the charge except to counsel, witnesses, and as required to preserve evidence.

15. SOURCES AND REFERENCES

• Kentucky Civil Rights Act, KRS Chapter 344 — https://apps.legislature.ky.gov/law/statutes/chapter.aspx?id=38920
• KRS 344.200 (Filing of complaint) — https://apps.legislature.ky.gov/law/statutes/chapter.aspx?id=38920
• KRS 344.230 (Remedies and orders)
• KRS 344.240 (Judicial review)
• KRS 344.270 (Election of remedies)
• KRS 344.450 (Civil remedies for injunction and damages) — https://apps.legislature.ky.gov/law/statutes/statute.aspx?id=32648
• 104 KAR 1:020 et seq. (KCHR procedural regulations) — https://apps.legislature.ky.gov/law/kar/titles/104/
• Kentucky Commission on Human Rights — https://kchr.ky.gov/
• KCHR File a Complaint — https://kchr.ky.gov/Pages/File-a-Complaint.aspx
• KCHR Frequently Asked Questions — https://kchr.ky.gov/About/Pages/FAQs.aspx
• U.S. Equal Employment Opportunity Commission — https://www.eeoc.gov/
• EEOC Louisville Area Office — https://www.eeoc.gov/field-office/louisville/location
• HUD Office of Fair Housing and Equal Opportunity — https://www.hud.gov/program_offices/fair_housing_equal_opp
• Vaezkoroni v. Domino's Pizza, Inc., 914 S.W.2d 341 (Ky. 1995)
• Clifton v. Midway College, 702 S.W.2d 835 (Ky. 1985)
• Wilson v. Lowe's Home Center, 75 S.W.3d 229 (Ky. App. 2001)
• Ammerman v. Bd. of Educ. of Nicholas Cnty., 30 S.W.3d 793 (Ky. 2000)
• Kentucky Dep't of Corrections v. McCullough, 123 S.W.3d 130 (Ky. 2003)
• Williams v. Wal-Mart Stores, Inc., 184 S.W.3d 492 (Ky. 2005)
• Howard Baer, Inc. v. Schave, 127 S.W.3d 589 (Ky. 2003)
• Brooks v. Lexington-Fayette Urban Cnty. Hous. Auth., 132 S.W.3d 790 (Ky. 2004)
• Meyers v. Chapman Printing Co., Inc., 840 S.W.2d 814 (Ky. 1992)
• Bostock v. Clayton County, 590 U.S. 644 (2020)
• National Railroad Passenger Corp. v. Morgan, 536 U.S. 101 (2002)
• Williams v. CSX Transp. Co., 643 F.3d 502 (6th Cir. 2011) (scope of charge)
• Title VII of the Civil Rights Act of 1964, 42 U.S.C. § 2000e et seq.
• Americans with Disabilities Act, 42 U.S.C. § 12101 et seq.
• Age Discrimination in Employment Act, 29 U.S.C. § 621 et seq.
• Fair Housing Act, 42 U.S.C. § 3601 et seq.
• Louisville Metro Code of Ordinances, Chapter 92 (Fairness Ordinance) — https://library.municode.com/ky/louisville_-_jefferson_county_metro_government
• Lexington-Fayette Urban County Government Code (Fairness Ordinance) — https://www.lexingtonky.gov/

Disclaimer: This template is provided for informational purposes only and does not constitute legal advice. An attorney licensed in Kentucky must review and customize this document before submission. KCHR procedures, intake forms, worksharing arrangements, and case law on election-of-remedies are amended periodically; verify the current process at kchr.ky.gov before filing.