Department of Civil Rights

Velma J. Korbel, Director

350 S. 5th St., Room 239
Minneapolis, MN 55415

Phone: (612) 673-3012
Fax: (612) 673-2599
TTY: (612) 673-2157

Office Hours:
8:30 a.m.–4:30 p.m.
Monday – Friday

Complaint Investigations Division - Civil Rights Complaint Form

Online Discrimination Complaint Form

If you feel that you have been discriminated against in the City of Minneapolis within the last 365 days, please fill out a discrimination complaint form below.

Please answer all questions honestly and openly to the best of your ability. Information related to the complaint is confidential and will not be released to the public.

Discrimination Complaint Form

  

Personal Information





  

  






  
 

  
 

Area/Basis for Claim of Discrimination

In what area do you feel you were discriminated?

 

What is the basis for your claim? (Check all that apply & give specifics in the related textbox)

Race 
Color 
Religion 
Age 
Disability 
Ancestry 
Creed 
Sex 
Gender Identity 
Sexual Orientation 
Sexual Harassment 
Marital Status 
Public Assistance 
National Origin   
Familial Status 
Registered Domestic Partner 
 

 

Do you have attorney representation?

 
 
 

  
 

Have you filed a complaint with any other agency?

 

If yes, please answer below:

 

 
 

Do you plan to file a court action?

  

 

The Organization that I am complaining about is:










  

Complete this portion ONLY if Employment Discrimination Claim

Fewer than 15 
15-100 
100+ 
Unknown

Your Employment Information
 
 
 
 
Discharge 
Lay-off 
Quit


 

Witnesses


  

  

  

 I hereby certify that the information in this complaint is true and accurate to the best of my knowledge and belief. I understand that this is the first step to initiating a Charge of Discrimination and that I may be requested to provide further information. You must certify that the information in this complaint is true and accurate to the best of your knowledge. Please check the box.

Information you provide is subject to the Minnesota Government Data Practices Act. This law classifies certain information as available to the public on request.

Last updated Jul 26, 2019

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Accessibility:
For reasonable accommodations or alternative formats, contact 311.
People who are deaf or hard of hearing can use a relay service to call 311 at 612-673-3000.
TTY users can call 612-673-2157 or 612-673-2626.

Para asistencia 612-673-2700, Yog xav tau kev pab, hu 612-637-2800, Hadii aad Caawimaad u baahantahay 612-673-3500. 

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