Utah Antidiscrimination & Labor Division (UALD) Charge of Discrimination

CHARGE OF DISCRIMINATION — UTAH ANTIDISCRIMINATION & LABOR DIVISION (UALD)

(Dual-Filed with U.S. Equal Employment Opportunity Commission — Work-Share Agreement)

TABLE OF CONTENTS

1. Filing Information
2. Charging Party Information
3. Respondent (Employer) Information
4. Basis of Discrimination — Protected Class(es)
5. Discriminatory Action(s) Alleged
6. Statement of Particulars
7. Date(s) of Discrimination and Timeliness
8. Continuing Action / Hostile Work Environment
9. Witnesses and Evidence
10. Relief Requested
11. Verification and Signature
12. Attachments and Cover Letter to UALD
13. Utah Practice Notes
14. Sources and References

1. FILING INFORMATION

Filed With:

Utah Antidiscrimination & Labor Division (UALD)
Utah Labor Commission
160 East 300 South, 3rd Floor
P.O. Box 146600
Salt Lake City, UT 84114-6600
Telephone: (801) 530-6800
Fax: (801) 530-7609
Online Portal: https://mylc.utah.gov/ed-applications
Web: https://laborcommission.utah.gov/divisions/utah-antidiscrimination-and-labor-uald/

Cross-Filed With:

U.S. Equal Employment Opportunity Commission (EEOC) — pursuant to UALD-EEOC Work-Share Agreement (29 C.F.R. § 1601.13)

Charge Number (assigned by UALD): [________________________________]

EEOC Charge Number: [________________________________]

Filing Date: [__/__/____]

2. CHARGING PARTY INFORMATION

3. RESPONDENT (EMPLOYER) INFORMATION

4. BASIS OF DISCRIMINATION — PROTECTED CLASS(ES)

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

• ☐ Race — specify: [________]
• ☐ Color
• ☐ Sex / Gender
• ☐ Pregnancy, Childbirth, or Pregnancy-Related Conditions
• ☐ Age (40 or older) — date of birth: [__/__/____]
• ☐ Religion — specify: [________]
• ☐ National Origin — specify: [________]
• ☐ Disability (actual, perceived, or record of)
• ☐ Sexual Orientation
• ☐ Gender Identity
• ☐ Retaliation (for engaging in protected activity)
• ☐ Religious / Moral / Political Expression (S.B. 296, codified protections)

5. DISCRIMINATORY ACTION(S) ALLEGED

The discrimination consisted of (check all that apply):

• ☐ Termination / Discharge
• ☐ Failure to Hire
• ☐ Failure to Promote
• ☐ Demotion
• ☐ Reduction in Pay or Hours
• ☐ Disciplinary Action / Write-Up
• ☐ Denial of Reasonable Accommodation (disability or religion)
• ☐ Harassment / Hostile Work Environment
• ☐ Sexual Harassment (quid pro quo or hostile environment)
• ☐ Constructive Discharge
• ☐ Retaliation
• ☐ Different Terms and Conditions of Employment
• ☐ Denial of Leave (FMLA, pregnancy, other)
• ☐ Other: [________________________________]

6. STATEMENT OF PARTICULARS

I, [CHARGING PARTY NAME], submit this Charge of Discrimination against [EMPLOYER NAME] ("Respondent") under the Utah Antidiscrimination Act, Utah Code § 34A-5-101 et seq., and applicable federal civil rights laws, and state as follows:

6.1. I was hired by Respondent on [__/__/____] as [JOB TITLE]. My most recent rate of pay was $[AMOUNT] per [hour / week / year], and my most recent supervisor was [SUPERVISOR NAME].

6.2. Throughout my employment, I performed my duties competently and met or exceeded Respondent's legitimate performance expectations, as reflected in [performance reviews / awards / metrics].

6.3. I am a member of the following protected class(es): [describe — e.g., I am a 52-year-old African-American woman; I have a disability (specify); I am a member of the LDS faith; I am gay; etc.].

6.4. Beginning on or about [__/__/____], I was subjected to discriminatory and/or harassing conduct by Respondent, as follows:

6.4.1. [Incident 1 — date, location, actor, statements/conduct, witnesses]

6.4.2. [Incident 2 — date, location, actor, statements/conduct, witnesses]

6.4.3. [Incident 3 — date, location, actor, statements/conduct, witnesses]

6.5. On [__/__/____], I engaged in protected activity by [reporting harassment to HR / requesting a religious or disability accommodation / filing an internal complaint / opposing discriminatory practices / participating in an investigation].

6.6. After my protected activity, Respondent [describe retaliation — disciplinary action, schedule changes, isolation, termination] on [__/__/____].

6.7. On [__/__/____], Respondent took the following adverse employment action against me: [describe — termination / demotion / pay cut / etc.]. The reason given by Respondent was [stated reason], which I believe is pretextual because:

• [Inconsistency 1 — e.g., similarly situated employees outside my protected class were not disciplined for the same conduct];
• [Inconsistency 2 — e.g., the stated reason is contradicted by my performance record];
• [Inconsistency 3 — e.g., the temporal proximity to my protected activity].

6.8. Similarly situated employees outside my protected class(es) were treated more favorably, including [name comparators, describe their treatment].

6.9. I believe Respondent's actions were motivated by unlawful discrimination on the basis of my [PROTECTED CLASS] in violation of Utah Code § 34A-5-106 and parallel federal civil rights laws.

7. DATE(S) OF DISCRIMINATION AND TIMELINESS

7.1. This Charge is timely filed within 180 days of the most recent alleged discriminatory act, as required by Utah Code § 34A-5-107(1)(c).

7.2. To the extent any individual act occurred more than 180 days before filing, Charging Party invokes the continuing-violation doctrine and/or the EEOC 300-day deferral period for federal claims.

8. CONTINUING ACTION / HOSTILE WORK ENVIRONMENT

8.1. ☐ Charging Party alleges a continuing course of conduct constituting a hostile work environment, with discrete acts and harassment continuing into the 180-day period under Nat'l R.R. Passenger Corp. v. Morgan, 536 U.S. 101 (2002).

8.2. ☐ Charging Party alleges discrete adverse actions, the most recent of which occurred within the 180-day period.

9. WITNESSES AND EVIDENCE

Documentary Evidence (attached or in Charging Party's possession):

• ☐ Pay stubs / W-2 (required for filing)
• ☐ Offer letter / employment contract
• ☐ Employee handbook / policies
• ☐ Performance reviews
• ☐ Disciplinary records
• ☐ Termination notice
• ☐ Internal complaint / HR correspondence
• ☐ Email / text messages
• ☐ Witness statements
• ☐ Medical records (for disability/pregnancy/accommodation claims)
• ☐ Demographic data on workforce composition
• ☐ Other: [________________________________]

10. RELIEF REQUESTED

Charging Party requests the following relief through UALD:

• ☐ Reinstatement to former position with full seniority and benefits
• ☐ Back pay and benefits from the date of adverse action
• ☐ Front pay (if reinstatement is impracticable)
• ☐ Restoration of seniority, leave, and other benefits
• ☐ Compensatory damages for emotional distress (federal claims; UAA limited to make-whole relief)
• ☐ Punitive damages (federal claims only)
• ☐ Reasonable accommodation (specify): [________________________________]
• ☐ Cease-and-desist order
• ☐ Posting of notice and remedial training
• ☐ Reasonable attorney's fees and costs
• ☐ Other: [________________________________]

11. VERIFICATION AND SIGNATURE

I declare under penalty of perjury under the laws of the State of Utah that I have read the foregoing Charge of Discrimination and that the facts stated therein are true and correct to the best of my knowledge, information, and belief.

I want this charge dual-filed with the EEOC under the UALD-EEOC Work-Share Agreement: ☐ Yes ☐ No

[________________________________]

Signature of Charging Party

[CHARGING PARTY NAME]

Date: [__/__/____]

NOTARY ACKNOWLEDGMENT

State of Utah, County of [________________]

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

[________________________________]

Notary Public

(My Commission Expires: [_______________])

12. ATTACHMENTS AND COVER LETTER TO UALD

[CHARGING PARTY NAME]

[ADDRESS]

[CITY, UT ZIP]

Date: [DATE]

Utah Antidiscrimination & Labor Division
Utah Labor Commission
160 East 300 South, 3rd Floor
P.O. Box 146600
Salt Lake City, UT 84114-6600

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

Dear Investigator:

Enclosed please find my completed and notarized Charge of Discrimination against [EMPLOYER NAME] under the Utah Antidiscrimination Act, Utah Code § 34A-5-101 et seq. I respectfully request that UALD:

1. Open an investigation under Utah Code § 34A-5-107;
2. Cross-file this Charge with the U.S. Equal Employment Opportunity Commission under the UALD-EEOC Work-Share Agreement;
3. Notify Respondent and offer voluntary mediation;
4. Conduct a thorough investigation, including interviews of the witnesses identified herein and review of the documentary evidence attached or available upon subpoena.

Enclosures:

• ☐ Notarized Charge of Discrimination
• ☐ Intake Questionnaire (My-LC submission confirmation)
• ☐ W-2 / pay stubs
• ☐ Termination notice / final pay record
• ☐ Performance reviews
• ☐ Internal complaint correspondence
• ☐ Witness list with contact information
• ☐ Documentary evidence (specify list)
• ☐ Medical records (sealed; for disability/pregnancy claims)
• ☐ Other: [________________________________]

Please direct all correspondence to the address above or by email to [EMAIL]. I am represented by counsel: ☐ Yes (see below) ☐ No.

Counsel for Charging Party (if any):

[ATTORNEY NAME], Utah State Bar No. [####]

[LAW FIRM NAME]

[ADDRESS]

[CITY, UT ZIP]

Telephone: [___-___-____]

Email: [EMAIL]

Sincerely,

[________________________________]

[CHARGING PARTY NAME]

13. UTAH PRACTICE NOTES

• 180-day deadline is jurisdictional. Utah Code § 34A-5-107(1)(c) requires filing within 180 days of the alleged discriminatory act. Missed deadline generally extinguishes the UAA claim. The federal 300-day deferral period applies only to federal Title VII / ADA / ADEA claims via EEOC after UALD work-share referral.
• Exclusive original jurisdiction in UALD. No private right of action lies in Utah state district court for UAA employment claims. See Utah Code § 34A-5-107. UALD investigates; the Director issues a Determination; an aggrieved party may request an evidentiary hearing before a Utah Labor Commission ALJ within 30 days; further review proceeds to the Utah Labor Commission and then to the Utah Court of Appeals on a writ of review under Utah Code § 63G-4-403.
• Federal action terminates UALD proceeding. Under Utah Code § 34A-5-107(15)(a), commencement of a federal action under federal law for relief based on conduct prohibited by the UAA bars commencement or continuation of a Commission adjudicative proceeding on the same claim. Sequence carefully if pursuing parallel federal claims.
• Filing process — start with the Intake Questionnaire (IQ). Submit the IQ online at https://mylc.utah.gov/ed-applications. UALD intake will create a formal Charge for signature. The Charge must be notarized; UALD provides free notary services in person.
• Dual-filing with EEOC. Indicate cross-filing on the Charge. The work-share agreement (29 C.F.R. § 1601.13) means filing with one agency typically satisfies filing with the other. Federal claims (Title VII / ADA / ADEA) require an EEOC charge for court access; § 1981 (race) does not.
• Employer threshold. 15+ employees in 20+ weeks (current or preceding year) under Utah Code § 34A-5-102(1)(i)(B)(I). Smaller employers are not covered by the UAA (though some local ordinances and federal § 1981/Equal Pay Act may still apply).
• Religious organization exemption. Utah Code § 34A-5-108 exempts religious organizations, their affiliates, religious schools, and the Boy Scouts of America from UAA employment provisions. Evaluate carefully.
• Protected expression (S.B. 296). In addition to the standard protected classes, the UAA protects employees' reasonable expression of religious, moral, or political beliefs in the workplace and outside the workplace, on equal terms with similar expressions allowed by the employer. This is a unique Utah protection — preserve any related claims.
• H.B. 257 (2024) note. H.B. 257 added "biological sex" definitions for purposes of public-school and government-facility sex-designated spaces (Title 53G, 63G, and related). It does NOT amend § 34A-5-106's gender-identity protections, but counsel for public-sector or special-district (Title 17B) charging parties should evaluate any H.B. 257 cross-cutting issues for bathroom/locker-room accommodation claims.
• Mediation. UALD offers voluntary mediation early in the process. Mediation is confidential and non-binding; the mediator does not issue a determination or maintain a record.
• Investigation timeline. UALD typically completes investigations in 6-12 months. Both parties receive a Determination explaining the Director's findings.
• Right-to-sue. After 180 days from filing (and upon request), the EEOC will issue a Notice of Right to Sue for federal claims. The 90-day window to file in federal court runs from receipt.
• Wage claim distinction. UALD also handles wage and pay-equity claims separately under Utah Code § 34A-5-106(1)(c)(i) (equal pay) and the Utah Payment of Wages Act (Title 34, Chapter 28). File the appropriate form for the claim type.

14. SOURCES AND REFERENCES

• Utah Antidiscrimination & Labor Division (UALD) — https://laborcommission.utah.gov/divisions/utah-antidiscrimination-and-labor-uald/
• UALD Employment Discrimination — https://laborcommission.utah.gov/divisions/utah-antidiscrimination-and-labor-uald/employment-discrimination/
• UALD Forms — https://laborcommission.utah.gov/all-forms/uald-forms/
• My-LC Online Filing Portal — https://mylc.utah.gov/ed-applications
• Utah Code § 34A-5-101 et seq. — https://le.utah.gov/xcode/Title34A/Chapter5/34A-5.html
• Utah Code § 34A-5-106 — https://le.utah.gov/xcode/Title34A/Chapter5/34A-5-S106.html
• Utah Code § 34A-5-107 — https://le.utah.gov/xcode/Title34A/Chapter5/34A-5-S107.html
• Utah Code § 34A-5-108 — https://le.utah.gov/xcode/Title34A/Chapter5/34A-5-S108.html
• S.B. 296 (2015) — https://le.utah.gov/~2015/bills/static/sb0296.html
• H.B. 257 (2024) — https://le.utah.gov/~2024/bills/hbillenr/HB0257.htm
• Utah Administrative Procedures Act, § 63G-4-101 et seq. — https://le.utah.gov/xcode/Title63G/Chapter4/63G-4.html
• EEOC — https://www.eeoc.gov/
• EEOC-State Work-Share Agreements — 29 C.F.R. § 1601.13
• Nat'l R.R. Passenger Corp. v. Morgan, 536 U.S. 101 (2002) (continuing violation)
• Bostock v. Clayton County, 590 U.S. 644 (2020) (Title VII SO/GI)

Disclaimer: This template is provided for informational purposes only and does not constitute legal advice. UALD has exclusive original jurisdiction over Utah Antidiscrimination Act employment claims, and the 180-day filing deadline under Utah Code § 34A-5-107(1)(c) is strictly enforced. An attorney licensed in Utah should review this Charge before submission. Verify all citations and procedural requirements against current UALD rules and the Utah Code.