Maine Human Rights Commission Charge of Discrimination

CHARGE OF DISCRIMINATION — MAINE HUMAN RIGHTS COMMISSION

Filed pursuant to 5 M.R.S. § 4611

Cross-filed with U.S. Equal Employment Opportunity Commission

1. AGENCY ADDRESSEE

Maine Human Rights Commission

51 State House Station

Augusta, Maine 04333-0051

Telephone: (207) 624-6290

Email: [email protected]

Online intake: https://www.maine.gov/mhrc/file

2. PARTIES

2.1 Complainant (You)

2.2 Respondent (Party Charged)

2.3 Additional Respondents

3. JURISDICTIONAL CHECKLIST

☐ Last act of discrimination occurred within the last 300 days (5 M.R.S. § 4611).

☐ Discriminatory act occurred in the State of Maine OR involved a Maine respondent OR involved a Maine-located transaction (employment site, rental unit, business, school, etc.).

☐ Respondent is a covered entity within the meaning of 5 M.R.S. § 4553 (employer with 1+ employee for most claims; housing provider; place of public accommodation; educational institution; credit-extender).

☐ Complainant is a member of a class protected by the MHRA.

☐ This charge is sworn under oath as required by 5 M.R.S. § 4611.

4. AREA(S) OF DISCRIMINATION (Check all that apply)

☐ Employment (5 M.R.S. § 4571 et seq.)

☐ Housing (5 M.R.S. § 4581-A et seq.)

☐ Public accommodation (5 M.R.S. § 4591 et seq.)

☐ Education (5 M.R.S. § 4601 et seq.)

☐ Extension of credit (5 M.R.S. § 4595 et seq.)

☐ Whistleblower / Retaliation (5 M.R.S. § 4633; 26 M.R.S. § 833)

☐ Maine Civil Rights Act bias-motivated interference (5 M.R.S. § 4681)

5. PROTECTED BASIS / BASES (Check all that apply)

☐ Race

☐ Color

☐ National origin

☐ Ancestry

☐ Sex (including pregnancy, childbirth, lactation)

☐ Sexual orientation

☐ Gender identity / gender expression

☐ Physical disability

☐ Mental disability

☐ Religion / creed

☐ Age (40+ for employment)

☐ Familial status (housing)

☐ Receipt of public assistance (housing/credit)

☐ Receipt of a protection-from-abuse order (housing)

☐ Retaliation for protected activity

☐ Other (specify): [_______________]

6. ADVERSE ACTIONS (Check all that apply)

☐ Termination / discharge

☐ Failure to hire / failure to promote / demotion

☐ Discriminatory discipline / suspension

☐ Unequal pay or benefits

☐ Harassment / hostile work environment

☐ Failure to provide reasonable accommodation (disability / religion / pregnancy)

☐ Constructive discharge

☐ Refusal to rent / sell / negotiate housing

☐ Discriminatory terms in housing or financing

☐ Eviction

☐ Refusal of service / unequal terms in public accommodation

☐ Denial of educational opportunity / unequal treatment in school

☐ Retaliation for opposing discrimination or filing a charge

☐ Other (specify): [_______________]

7. KEY DATES

8. SWORN STATEMENT OF FACTS

8.1. Background. I, [COMPLAINANT NAME], [was employed by / rented from / sought goods or services from / attended / applied for credit with] Respondent [RESPONDENT NAME] beginning on or about [__/__/____] in the capacity of [ROLE / TENANCY / TRANSACTION].

8.2. Protected class. I am a member of a protected class under the MHRA on the basis of my [PROTECTED CHARACTERISTIC(S)]. Specifically, [BRIEF DESCRIPTION — e.g., I am a Black woman; I have been diagnosed with [DISABILITY]; I am 58 years old; I am a transgender man; I practice [RELIGION]].

8.3. Qualification / good standing. At all relevant times I [performed my job duties satisfactorily / paid rent on time / met the terms of the transaction / was qualified for the opportunity], as evidenced by [performance reviews / payment history / credentials / waitlist status].

8.4. Discriminatory conduct. Beginning on or about [__/__/____], Respondent, acting through [NAMES / TITLES], engaged in the following conduct toward me:

• On [__/__/____], [DESCRIBE INCIDENT #1 with specifics — who said/did what, where, witnesses].
• On [__/__/____], [DESCRIBE INCIDENT #2].
• On [__/__/____], [DESCRIBE INCIDENT #3].

8.5. Evidence of discriminatory motive. I believe Respondent's conduct was motivated by my [PROTECTED CHARACTERISTIC] based on:

• [Direct evidence — verbatim slurs, comments, or written statements];
• [Comparator evidence — name(s) and treatment of similarly situated persons outside the protected class];
• [Departures from policy or shifting/pretextual explanations offered by Respondent];
• [Statistical / pattern evidence, if available].

8.6. Internal complaint and response. On [__/__/____], I reported the conduct to [NAME / TITLE — supervisor / HR / property manager / school administrator] by [verbal complaint / written email / formal grievance]. [Describe Respondent's response or lack thereof.]

8.7. Retaliation. After my complaint, Respondent [escalated the conduct / disciplined me / reduced my hours / terminated me / served a notice to quit / refused service] on [__/__/____], which I believe was in retaliation for my opposition to the discrimination.

8.8. Harm suffered. As a result of Respondent's conduct I have suffered [lost wages / lost housing / out-of-pocket medical expenses / emotional distress / humiliation / mental anguish / anxiety / loss of professional reputation], in an amount to be determined.

8.9. Witnesses. The following individuals have personal knowledge of the facts described:

• [NAME — TITLE / RELATIONSHIP — CONTACT]
• [NAME — TITLE / RELATIONSHIP — CONTACT]
• [NAME — TITLE / RELATIONSHIP — CONTACT]

8.10. Documentary evidence available. Attached or available on request:

☐ Personnel file / employment records

☐ Lease / rental agreement / payment records

☐ Performance evaluations

☐ Disciplinary notices / termination letter / eviction notice

☐ Emails / text messages / voicemails

☐ Audio / video recordings

☐ Medical records (disability cases)

☐ Pay stubs / W-2s / 1099s

☐ Witness statements / declarations

☐ Photographs

☐ Other: [_______________]

9. RELIEF SOUGHT

☐ Investigation and finding of reasonable grounds (5 M.R.S. § 4612)

☐ Conciliation / negotiated resolution

☐ Reinstatement to former position

☐ Hiring / promotion

☐ Restoration of housing / withdrawal of eviction

☐ Back pay and benefits

☐ Front pay

☐ Compensatory damages for emotional distress and reputational harm

☐ Punitive damages

☐ Civil penal damages (5 M.R.S. § 4613(2)(B))

☐ Attorney's fees and costs (5 M.R.S. § 4614)

☐ Posting of notice and policy reform

☐ Right-to-sue letter (5 M.R.S. § 4612(6)) — issue automatically after 180 days or upon written request

10. CROSS-FILING ELECTION (EEOC Work-Sharing)

☐ I want this charge DUAL-FILED with the U.S. Equal Employment Opportunity Commission for parallel federal Title VII / ADA / ADEA / GINA / Equal Pay Act / Pregnant Workers Fairness Act claims.

☐ I want this charge DUAL-FILED with the U.S. Department of Housing and Urban Development for parallel Fair Housing Act claims.

☐ I do NOT wish to cross-file at this time. (Note: this may waive federal remedies.)

11. PRIOR / PARALLEL PROCEEDINGS

☐ I have NOT filed any prior complaint relating to these facts.

☐ I have filed the following related actions (provide copies):

• Agency / Court: [_______________]
• Case / charge number: [_______________]
• Date filed: [__/__/____]
• Status: [_______________]

12. VERIFICATION (Required by 5 M.R.S. § 4611)

I, [COMPLAINANT NAME], having been duly sworn, depose and say:

1. I am the Complainant in the foregoing Charge of Discrimination.

2. I have read and understand the contents of this Charge.

3. The facts stated above are true to the best of my knowledge, information, and belief.

4. I authorize the Maine Human Rights Commission to investigate my charge and to share the charge with the U.S. Equal Employment Opportunity Commission and any other federal or state agency with concurrent jurisdiction over the matters alleged.

5. I declare under the penalties of perjury under the laws of the State of Maine that the foregoing is true and correct.

[________________________________]

[COMPLAINANT SIGNATURE]

Date: [__/__/____]

STATE OF MAINE

COUNTY OF [COUNTY], ss.

Sworn to and subscribed before me this [____] day of [_______________], 20[____], by [COMPLAINANT NAME], who is personally known to me or who produced [FORM OF ID] as identification.

[________________________________]

Notary Public / Attorney-at-Law

Print Name: [_______________]

(My Commission Expires: [_______________])

13. ATTORNEY INFORMATION (If represented)

I authorize the MHRC and the EEOC to communicate directly with my attorney regarding this charge.

[________________________________]

[COMPLAINANT SIGNATURE]

14. SUBMISSION CHECKLIST

☐ Charge sworn before notary

☐ MHRC Intake Questionnaire completed and attached

☐ All exhibits labeled and attached

☐ Witness contact list attached

☐ Cross-filing election made (Section 10)

☐ Copy retained for complainant's records

☐ Method of submission confirmed:

• ☐ MHRC online intake portal (https://www.maine.gov/mhrc/file)
• ☐ U.S. Mail to 51 State House Station, Augusta, ME 04333-0051
• ☐ In-person delivery
• ☐ Fax to (207) 624-8729
• ☐ Email scan to [email protected]

15. MAINE PRACTICE NOTES

• Strict 300-day deadline. 5 M.R.S. § 4611. The MHRC and Maine Law Court enforce this deadline strictly. Continuing-violation theory may apply for hostile-environment claims, but each discrete adverse action (discharge, demotion, denial of promotion) restarts its own 300-day clock. See Nat'l R.R. Passenger Corp. v. Morgan, 536 U.S. 101 (2002), applied by Maine courts.
• Sworn requirement. § 4611 requires the complaint to be "under oath." A charge submitted online without notarization is typically perfected by a follow-up sworn statement; do not assume the online portal alone satisfies the oath requirement.
• EEOC dual-filing. Maine is a § 706 deferral jurisdiction. Filing with the MHRC equals filing with the EEOC for Title VII, ADA, ADEA, GINA, and PWFA claims under the work-sharing agreement (29 C.F.R. § 1601.13). Federal deadline therefore is 300 days, not 180.
• HUD dual-filing for housing. Filing with MHRC also triggers concurrent FHA processing where the charge alleges housing discrimination on a protected basis covered by 42 U.S.C. § 3604.
• 180-day right-to-sue. A complainant who wishes to file in court may request a right-to-sue letter from MHRC at any time after 180 days from the charge filing if MHRC has not concluded its investigation or reached conciliation. 5 M.R.S. § 4612(6). The letter is a prerequisite to MHRA fee/damages recovery under § 4622.
• Two-year court deadline. A civil action under the MHRA must be filed within two years of the discriminatory act. 5 M.R.S. § 4613(2-C). Pendency of the MHRC charge does not automatically toll the two-year court deadline — calendar both deadlines.
• Investigation process. MHRC assigns an investigator; both parties submit position statements; Commission staff issues an investigator's report; the Commissioners vote at a public meeting on whether reasonable grounds exist. If reasonable grounds are found, conciliation follows; if conciliation fails, the Commission may sue or issue a right-to-sue letter.
• Confidentiality. MHRC investigation files are generally confidential pending Commission action under § 4612.
• Settlement value. Many MHRC charges resolve in pre-determination conciliation. Document damages and attorney's fees thoroughly to anchor settlement value.
• Aiding-and-abetting. Name the individual decision-maker(s) as additional respondents to preserve § 4633(2) personal liability for any subsequent civil action.

16. SOURCES AND REFERENCES

• Maine Human Rights Commission — File a Complaint: https://www.maine.gov/mhrc/file
• MHRC — Instructions for Intake Form: https://www.maine.gov/mhrc/file/instructions
• MHRC — After a Complaint Has Been Filed: https://www.maine.gov/mhrc/file/after
• 5 M.R.S. ch. 337 (Maine Human Rights Act): https://www.mainelegislature.org/legis/statutes/5/title5ch337sec0.html
• 5 M.R.S. § 4611 (Filing): https://www.mainelegislature.org/legis/statutes/5/title5sec4611.html
• 5 M.R.S. § 4612 (Procedure on complaints): https://www.mainelegislature.org/legis/statutes/5/title5sec4612.html
• 5 M.R.S. § 4613 (Procedure in Superior Court): https://www.mainelegislature.org/legis/statutes/5/title5sec4613.html
• 5 M.R.S. § 4622 (Exhaustion): https://www.mainelegislature.org/legis/statutes/5/title5sec4622.html
• MHRC Procedural Rules (94-348 C.M.R.): https://www.maine.gov/sos/cec/rules/94/chaps94.htm
• EEOC: https://www.eeoc.gov/
• EEOC/State Work-Sharing (29 C.F.R. § 1601.13): https://www.ecfr.gov/current/title-29/subtitle-B/chapter-XIV/part-1601/subpart-B/section-1601.13
• HUD Fair Housing: https://www.hud.gov/program_offices/fair_housing_equal_opp

Disclaimer: This template is provided for informational purposes only and does not constitute legal advice. An attorney licensed in Maine should review and customize this document before submission. Statutes, agency rules, and procedures change; verify all authorities before use.