Discrimination Complaint Form

City of Milwaukee Equal Rights Commission
City Hall, Room 606, 200 East Wells Street,
Milwaukee, WI 53202
Phone: (414) 286-5900
[email protected]
milwaukee.gov/ERC

The City of Milwaukee Equal Rights Commission can only investigate discrimination complaints that took place within the City of Milwaukee. If the discrimination took place outside of the City of Milwaukee, please call our office at (414) 286-5900 for a referral to the correct entity.

Complainant Information

In Red is Required

First Name:

Last Name:

Middle Initial:

Street Address:

City:

State:  

Zip:

Main Phone Number:  

Phone Type:

Other Phone Number:

Phone Type:

Email Address:

Respondent Information

(The person or entity you believed discriminated against you. Name only ONE respondent per form.)

Name:

Email:

Main Phone Number:

Street Address:

City:

State:

Zip:

This Complaint is About Housing   Public Acommodations   Employment

Basis for Discrimination

I believe the Respondent discriminated or took action against me because of:

Can select multiple

Discrimination Incident Information

Location of the incident:

Date of the incident:

Time of the incident:

Witness Name:

Witness Email:

Witness Phone:

Statement/Description of Discrimination

Write a brief, concise statement explaining in detail how you were discriminated against. Explain how the discrimination incident was related to the “Reason for Discrimination” box(es) you checked.

Desired Outcome

What would you like to have happen as a result of filing this complaint?

Do You Have Attorney Representation? Yes No

Attorney Name:

Email:

Phone:

Have You Filed a Complaint With Any Other Agency? Yes No

Agency Name:

Date Filed:

Signature

By signing my name in the space provided below I affirm that all information in this complaint is true and correct to the best of my knowledge and that the discrimination took place within the City of Milwaukee. 

By checking this box and typing my name below, I am electronically certifying my signature

Thank you for submitting your Discrimination Form. Someone will reach out to you as soon possible.