UNITED STATES DISTRICT COURTS EASTERN DISTRICT OF TEXAS ___________________DIVISION ________________________________ Case Number: __________________ ________________________________ ________________________________ Name of Plaintiff(s) vs ________________________________ ________________________________ ________________________________ Name of Defendant(s) COMPLAINT UNDER TITLE VII OF THE CIVIL RIGHTS ACT OF 1964 Note: If plaintiff is alleging employment discrimination based on race or color, please also see 42:U.S.C. 1981 1. This action is brought pursuant to Title VII of the Civil Rights Act of 1964 for employment discrimination. Jurisdiction is specifically conferred on the court by 42 U.S.C. 2000e-5. Equitable and other relief are also sought under 42 U.S.C. 2000e-5(g). 2.. Plaintiff, _____________________________________, is a citizen of the United States (name of plaintiff) and resides at ____________________________________________, _______________, (street address) (city) ______________________, ______________, _______________, _________________. (county) (state) (zip) (telephone) American LegalNet, Inc. www.FormsWorkFlow.com 3.. Defendant, ____________________________________, resides at, or its business is (name of defendant) located at ____________________________________________, _______________, (street address) (city) ______________________, ______________, _______________, _________________. (county) (state) (zip) (telephone) 4. Plaintiff sought employment from the defendant or was employed by the defendant at ______________________________________________, ______________________, (street address) (city) _____________________________, ________________________, ________________. (county) (state) (zip) 5. Defendant discriminated against plaintiff in the manner indicated in paragraphs 9 and 10 of the complaint on or about _______________________________________________. (month, day, year) 6. Plaintiff filed charges against the defendant with the Equal Employment Opportunity Commission charging defendant with the acts of discrimination indicated in paragraphs 9 and 10 of this complaint on or about _______________________________________. (month, day, year) 7. The Equal Employment Commission issued a Notice of Right to Sue which was received by plaintiff on ___________________________________________________. (month day, year) American LegalNet, Inc. www.FormsWorkFlow.com 8. Because of plaintiff's (1) _____ race, (2) _____ color, (3) _____ sex, (4) _____ national origin, defendant: a. b. c. d. _____ failed to employ plaintiff. _____ terminated plaintiff's employment. _____ failed to promote plaintiff. _____ Other ___________________________________________ ______________________________________________________ ______________________________________________________ 9. The circumstances under which the defendant discriminated against plaintiff were as follows: _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ _______________________________________________________________________ American LegalNet, Inc. www.FormsWorkFlow.com 10. The acts set forth in paragraph 9 of this complaint: a. b. c. _____ _____ _____ are still being committed by defendant. are no longer being committed by defendant. defendant may still be committing the acts. 11. Plaintiff attaches to this complaint a copy of the charges filed with the Equal Employment Opportunity Commission which charges are submitted as a brief statement of the facts supporting this complaint. WHEREFORE, Plaintiff prays that the Court grant the following relief to the plaintiff: a. b. c. d. _____ _____ _____ _____ Defendant be directed to employ plaintiff. Defendant be directed to re-employ plaintiff. Defendant be directed to promote plaintiff. Defendant be directed to ___________________ and that the Court grant such relief as may be appropriate, including injunctive orders, damages, costs and attorney's fees. _______________________________________________ (Signature of Plaintiff) American LegalNet, Inc. www.FormsWorkFlow.com