Washington State Human Rights Commission (WSHRC) Charge of Discrimination

CHARGE OF DISCRIMINATION

WASHINGTON STATE HUMAN RIGHTS COMMISSION (WSHRC)

Dual-Filed with the U.S. Equal Employment Opportunity Commission (EEOC) under the WSHRC-EEOC Worksharing Agreement ☐ Yes ☐ No

A. AGENCY FILING INFORMATION

To: Washington State Human Rights Commission
711 S. Capitol Way, Suite 402
P.O. Box 42490
Olympia, WA 98504-2490
Phone: (360) 753-6770
Web: https://www.hum.wa.gov/file-complaint

EEOC Charge No. (if dual-filed): [________________________________]
WSHRC Charge No. (assigned by agency): [________________________________]

B. COMPLAINANT INFORMATION

C. RESPONDENT INFORMATION

D. TYPE OF DISCRIMINATION ALLEGED

(Check all that apply)

Statutory basis (RCW Chapter 49.60):

• ☐ RCW 49.60.180 — Employment
• ☐ RCW 49.60.210 — Retaliation
• ☐ RCW 49.60.215 — Public Accommodation
• ☐ RCW 49.60.222 — Real Estate / Housing
• ☐ RCW 49.60.172 — HIV / Hepatitis C
• ☐ RCW 49.60.174 — Insurance / Credit
• ☐ Other: [________________________________]

Protected class(es):

• ☐ Race
• ☐ Creed / Religion
• ☐ Color
• ☐ National Origin
• ☐ Citizenship or Immigration Status
• ☐ Sex
• ☐ Pregnancy / Childbirth / Pregnancy-Related Conditions
• ☐ Marital Status
• ☐ Sexual Orientation
• ☐ Gender Identity / Gender Expression
• ☐ Age (40+)
• ☐ Honorably Discharged Veteran or Military Status
• ☐ Sensory, Mental, or Physical Disability
• ☐ Use of Trained Dog Guide or Service Animal
• ☐ HIV / AIDS / Hepatitis C Status
• ☐ Retaliation for Protected Activity

E. DATES OF DISCRIMINATORY CONDUCT

F. STATEMENT OF PARTICULARS

(Plain-English narrative — be specific as to who, what, when, where, and why Complainant believes the conduct was discriminatory)

1. Background. Complainant began [employment / patronage / housing tenancy] with Respondent on [__/__/____] as [POSITION / CAPACITY].

2. Protected Status. Complainant is [describe protected status — e.g., African American; female; age 52; person with PTSD; person living with HIV; lesbian; transgender; honorably discharged Navy veteran].

3. Discriminatory Acts. On or about [__/__/____], Respondent [describe specific conduct — e.g., terminated Complainant; refused to rent apartment 4B; denied service at lunch counter; refused reasonable accommodation for service animal; demoted Complainant after pregnancy disclosure].

4. Direct or Circumstantial Evidence. [Describe — direct statements, comparator evidence, deviation from policy, temporal proximity, statistical patterns, written communications].

5. Protected Activity (if retaliation alleged). On [__/__/____], Complainant engaged in protected activity by [describe — internal complaint, prior WSHRC/EEOC charge, accommodation request, opposition to discriminatory practice]. Respondent thereafter [describe adverse action], with a causal connection demonstrated by [temporal proximity / direct evidence / pattern].

6. Harm Suffered. Complainant has suffered [lost wages / lost housing / denial of services / emotional distress / humiliation / medical expenses / damage to reputation].

7. Comparators / Similarly Situated. [Identify persons outside protected class treated more favorably, where known].

8. Witnesses. [Names and contact information of witnesses, where known].

G. RELIEF REQUESTED

Complainant requests that WSHRC investigate and take appropriate action, including:

• ☐ Reinstatement / Hiring / Promotion
• ☐ Back Pay and Benefits
• ☐ Compensatory Damages (emotional distress, out-of-pocket losses)
• ☐ Reasonable Accommodation
• ☐ Policy Changes / Training
• ☐ Cease-and-Desist Order
• ☐ Conciliation Agreement
• ☐ Attorneys' Fees and Costs (per RCW 49.60.030(2) if matter proceeds to court)
• ☐ Other: [________________________________]

H. DUAL-FILING WITH EEOC

☐ Complainant elects to dual-file this charge with the U.S. Equal Employment Opportunity Commission under the WSHRC-EEOC Worksharing Agreement, to preserve federal claims under Title VII (42 U.S.C. § 2000e et seq.), the ADA (42 U.S.C. § 12101 et seq.), the ADEA (29 U.S.C. § 621 et seq.), and the Equal Pay Act (29 U.S.C. § 206(d)).

☐ Complainant requests that EEOC issue a Notice of Right to Sue at the conclusion of WSHRC proceedings (or after 180 days from filing) to permit court filing under federal law.

I. PRIOR PROCEEDINGS

☐ Complainant has NOT filed any prior charge or lawsuit regarding this matter.

☐ Complainant HAS filed the following prior proceedings:

J. VERIFICATION

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

Signed at [CITY, WA] on [__/__/____].

[________________________________]
[COMPLAINANT NAME], Complainant

K. NOTARIZATION (If Required)

State of Washington
County of [____________________]

Subscribed and sworn to before me on [__/__/____] by [COMPLAINANT NAME], who is personally known to me or who has produced [ID] as identification.

[________________________________]
Notary Public in and for the State of Washington
My Commission Expires: [__/__/____]

L. ATTORNEY INFORMATION (If Represented)

M. WASHINGTON PRACTICE NOTES

• ☐ Filing deadline. RCW 49.60.230 — 6 months for most claims; 1 year for real estate/pregnancy; 2 years for whistleblower retaliation. Compute from the LATEST discriminatory act in a continuing violation/hostile environment claim.
• ☐ No exhaustion required for WLAD court suit. Under RCW 49.60.030(2), a charge with WSHRC is NOT a prerequisite to filing in Washington Superior Court. The 3-year court SOL (RCW 4.16.080(2); Antonius v. King County, 153 Wn.2d 256 (2004)) runs independently of the 6-month WSHRC deadline.
• ☐ Right-to-sue not required. WSHRC does not need to issue a notice for the complainant to proceed to court under WLAD. EEOC must issue a right-to-sue letter for parallel federal claims under Title VII/ADA/ADEA.
• ☐ Federal preservation. Dual-file with EEOC to preserve Title VII / ADA / ADEA federal claims (300-day deadline in deferral states).
• ☐ WSHRC investigation phases. Intake → drafted charge → investigation → reasonable cause/no cause finding → conciliation or administrative hearing before an ALJ → final decision; appeal to superior court via writ.
• ☐ Confidentiality. WSHRC investigative file is confidential under WAC Chapter 162. Do not disseminate beyond counsel until a determination issues.
• ☐ Withdrawal / Election of Remedies. A complainant may withdraw the charge at any time to proceed in court. Consult counsel — a withdrawn charge generally does not bar a court action under WLAD, but coordinate with any pending federal claim.
• ☐ Retaliation prohibited. RCW 49.60.210 protects complainants from retaliation for filing. Document any post-filing adverse acts.

N. ATTACHMENTS / EXHIBITS

• ☐ Termination letter / adverse action notice
• ☐ Personnel file (if available)
• ☐ Internal complaints / HR correspondence
• ☐ Medical records (for disability or pregnancy claims)
• ☐ Photographs / videos
• ☐ Witness statements
• ☐ Lease / rental application (housing claims)
• ☐ Service denial documentation (public accommodation claims)
• ☐ Other: [________________________________]

O. SOURCES AND REFERENCES

• WSHRC — https://www.hum.wa.gov/
• WSHRC File a Complaint — https://www.hum.wa.gov/file-complaint
• RCW Chapter 49.60 — https://app.leg.wa.gov/rcw/default.aspx?cite=49.60
• RCW 49.60.230 — https://app.leg.wa.gov/rcw/default.aspx?cite=49.60.230
• RCW 49.60.240 — https://app.leg.wa.gov/rcw/default.aspx?cite=49.60.240
• WAC Chapter 162 — https://app.leg.wa.gov/wac/default.aspx?cite=162
• EEOC Seattle Field Office — https://www.eeoc.gov/field-office/seattle
• Antonius v. King County, 153 Wn.2d 256 (2004)
• Dailey v. North Coast Life Ins. Co., 129 Wn.2d 572 (1996)

Disclaimer: This template is provided for informational purposes only and does not constitute legal advice. The Washington Law Against Discrimination permits direct court filing without exhausting WSHRC; the choice to file an administrative charge is a strategic one. Verify all current addresses and procedures with WSHRC before filing. An attorney licensed in Washington should review this filing.