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Agreement Of Nondisclosure Form. This is a California form and can be use in Equal Employment Opportunity Commission Federal.
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Tags: Agreement Of Nondisclosure, 167, California Federal, Equal Employment Opportunity Commission
COURT
COUNTY . .
. . . . . . . . . .OF. . . . . . . . EQUAL EMPLOYMENT. OPPORTUNITY COMMISSION
.................... .............
:
AGREEMENT OF NONDISCLOSURE Index No.
Pursuant to Section 705g(1) of Title VII, the EEOC shall have power to cooperate with private individuals in order to accomplish the
:
Calendar No.
purpose of Title VIl. This same authority also applies to actions under the Americans with Disabilities Act.
:
PERSON REQUESTING DISCLOSURE
Plaintiff(s)
-against-
CHARGING PARTY
RESPONDENT
AGGRIEVED PERSON ON
WHOSE BEHALF CHARGE
IS FILED
NAMED PARTY IN CLASS
ACTION
AGGRIEVED PERSON IN
:
NAMED PARTY IN CLASS
ACTION
:
ATTORNEY REPRESENTING
RESPONDENT
CP
JUDICIAL SUBPOENA
AGGRIEVED PERSON
IN COMMISSIONER
CHARGE
AGGRIEVED PERSON ON
WHOSE BEHALF CHARGE IS
FILED
: COMMISSIONER CHARGE
Defendant(s)
:
CHARGE. NUMBER(S). OF. FILE(S). TO. BE. DISCLOSED . . . . . . . . . . . .
... .......... .. ...... .. .. ...........
THE PEOPLE OF THE STATE OF NEW YORK
TO
STATEMENT
I
GREETINGS:
, request disclosure of Commission case file(s) in
(Typed name)
WE COMMAND YOU, that all business and excuses being laid aside, you and each of you attend before
,
the Honorable
at the
Court
connection with contemplated or pending litigation. I agree that the information disclosed to me will not be made
located at
County of
in room
, on the
day of
, 20
, at
o'clock in the
noon, and at any recessed
public or used except in the normal give evidence as a witness in this action on the part of the
or adjourned date, to testify and course of a civil action or other proceeding instituted under Title VII or the
Americans with Disabilities Act involving such information.
Your failure to comply with this subpoena is punishable as a contempt of court and will make you liable to
In witness whereof, this behalf this subpoena was issued for a maximum penalty of $50 and all damages sustained as a
20
day of
the party on whose agreement is entered into as of the
result of your failure to comply.
by the Equal Employment Opportunity Commission representative named below and the person requesting
Court
disclosure. in
Witness, Honorable
County,
, one of the Justices of the
day of
, 20
(Attorney must sign above and type name below)
Person requesting disclosure (Signature and telephone number/area code)
Complete address
Attorney(s) for
EEOC representative (Signature and title)
Office and P.O. Address
EEOC FORM 167 (10/94)
Telephone No.:
Facsimile No.:
E-Mail Address:
Mobile Tel. No.:
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