EEOC Form 5 is the Charge of Discrimination, the form the U.S. Equal Employment Opportunity Commission (EEOC) prints for a person to describe who discriminated against them or others, on what basis and on which dates. It names the employer, labor organization, employment agency, apprenticeship committee or state or local government agency involved, and ends with a sworn declaration. On FillingPDF you can fill out the form online and download or print the completed PDF; the form and the agency's filing information are published by the EEOC.
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What is EEOC Form 5?
EEOC Form 5, Charge of Discrimination, is the U.S. Equal Employment Opportunity Commission form on which a person identifies the organization they believe discriminated against them or others, states the basis of the discrimination and the dates it took place, and describes what happened.
The form is built in a few blocks. The top of the page shows which agencies the charge is presented to: the EEOC and, if any, a State or local agency, each with a space for a charge number. Below it you enter your own name, home phone, year of birth and address. The next block names the employer, labor organization, employment agency, apprenticeship committee or state or local government agency, with its number of employees or members, phone number and address; room is given for two, and any further ones go under the particulars.
The middle of the page asks for the basis of the discrimination and the earliest and latest dates it took place. A larger area, THE PARTICULARS ARE, holds your narrative, and extra sheets may be attached if more paper is needed.
The bottom of the form contains the statement that you want the charge filed with both the EEOC and the State or local agency, if any, a notary block for use when State and local agency requirements call for it, and a declaration under penalty of perjury with the Charging Party's signature and date. The form carries a Privacy Act of 1974 notice and refers to an enclosed Privacy Act Statement to read before completing it.
Who needs to file EEOC Form 5?
A person who believes an employer, labor organization, employment agency, apprenticeship committee or state or local government agency discriminated against them or others completes EEOC Form 5. The form calls that person the Charging Party, and the Charging Party signs the sworn declaration at the bottom.
The form is written in the first person: you state that you want the charge filed with both the EEOC and the State or local agency, if any, that you will advise the agencies if your address or phone number changes, and that you will cooperate fully with them in processing the charge under their procedures.
The named organization may be one of the types listed on the form, and the form allows two to be entered in the dedicated blocks. If your charge involves more than two, you list the others under THE PARTICULARS ARE.
The form does not say who may sign for someone else or describe any exclusions, so questions about who can file a charge, or file for another person, should go to the EEOC through its page on filing a charge of discrimination.
When to file EEOC Form 5
You complete EEOC Form 5 when you are ready to present a charge of discrimination against an employer, labor organization, employment agency, apprenticeship committee or state or local government agency. The form prints no filing deadline of its own. It does ask for the earliest and latest dates the discrimination took place, so have those dates ready before you begin. Time limits and the steps that follow a charge are explained by the EEOC on its page about filing a charge of discrimination, so check it before you rely on any date.
Documents you need
- Extra sheet(s) continuing THE PARTICULARS ARE, only if the space on the form is not enough; the form says to attach additional paper if needed.
How to fill out EEOC Form 5
Read the Privacy Act notice
Before you begin, read the notice at the top of the form that it is affected by the Privacy Act of 1974, and the enclosed Privacy Act Statement it refers to.
Complete the Charge Presented To block
At the top, the form shows the agencies the charge is presented to, the EEOC and the State or local agency, if any, with a Charge No(s) space for each. Enter what applies to your charge.
Enter your name and contact details
Give your name (the form asks you to indicate Mr., Ms., Mrs., Miss, Dr., Hon., Rev., etc.), your Home Phone and your Year of Birth. Then enter your street address, city, state and ZIP code.
Name the organization you charge
In the Named is the Employer, Labor Organization, Employment Agency, Apprenticeship Committee, or State or Local Government Agency block, enter its name, number of employees or members, phone number and address.
Add a second organization if needed
Use the second name block for another respondent. If more than two are involved, list the additional ones under THE PARTICULARS ARE.
Describe the basis of discrimination
Under DISCRIMINATION BASED ON, state the basis on which you believe you or others were discriminated against.
Enter the dates
Under DATE(S) DISCRIMINATION TOOK PLACE, enter the Earliest date and the Latest date.
Write the particulars
In THE PARTICULARS ARE, describe what happened. If additional paper is needed, attach extra sheet(s).
Review the filing statement
Read the statement that you want the charge filed with both the EEOC and the State or local agency, if any, and that you will advise the agencies of any change of address or phone number and cooperate with them.
Handle the notary block if required
The NOTARY block is marked for use when necessary for State and Local Agency Requirements. If it applies, sign before the notary, who completes the SUBSCRIBED AND SWORN TO BEFORE ME line.
Sign, date and download the PDF
Sign as Charging Party and enter the date next to the declaration under penalty of perjury. Check every entry, then download or print the completed PDF from FillingPDF and submit it through the EEOC's channels.
How to submit EEOC Form 5
The form itself names no mailing address, portal, office or appointment rule, so the channel for presenting it is set by the EEOC. The agency explains how to file a charge on its page Filing a Charge of Discrimination.
Points the form does state:
- Where the charge goes: the top of the form shows the charge is presented to the EEOC and to a State or local agency, if any, and a printed statement says you want it filed with both.
- Signature and notary: the Charging Party signs and dates the declaration under penalty of perjury. The NOTARY block, marked for use when necessary for State and Local Agency Requirements, has the line SUBSCRIBED AND SWORN TO BEFORE ME THIS DATE (month, day, year).
- Extra pages: if more paper is needed for the particulars, attach extra sheet(s).
FillingPDF lets you fill out and download the PDF; submission follows the EEOC's channels described on its page.
Common mistakes to avoid
- Listing more than two organizations in the two name blocks instead of listing the additional ones under THE PARTICULARS ARE, as the form directs.
- Leaving out the earliest or the latest date under DATE(S) DISCRIMINATION TOOK PLACE.
- Running out of room in the particulars and not attaching extra sheet(s), which the form calls for when more paper is needed.
- Submitting the form unsigned: the declaration under penalty of perjury needs the Charging Party's signature and date.
- Signing the sworn statement before the notary when State or local agency requirements call for the NOTARY block, since it reads SUBSCRIBED AND SWORN TO BEFORE ME.
- Skipping the Privacy Act of 1974 notice and the enclosed Privacy Act Statement the form tells you to read before completing it.
- Not telling the agencies about a new address or phone number, which the form says you will do.
Frequently asked questions
What is EEOC Form 5?
EEOC Form 5 is the Charge of Discrimination of the U.S. Equal Employment Opportunity Commission. You use it to name the employer, labor organization, employment agency, apprenticeship committee or state or local government agency you believe discriminated against you or others, and to describe the basis, dates and particulars.
Can I fill out EEOC Form 5 online?
Yes. You can complete the fillable PDF on FillingPDF and download or print it. FillingPDF is an independent service and is not affiliated with the EEOC; it does not file the charge. You submit it through the EEOC's channels.
How many employers can I name on EEOC Form 5?
The form has two blocks for the named organization. If more than two are involved, the form tells you to list the rest under THE PARTICULARS ARE. Each block asks for the name, number of employees or members, phone number and address.
Does EEOC Form 5 have to be notarized?
Only when necessary. The NOTARY block is marked for use when necessary for State and Local Agency Requirements. Without that requirement, the form still has a declaration under penalty of perjury that the Charging Party signs and dates.
What dates do I enter on a Charge of Discrimination?
Enter the Earliest and the Latest date under DATE(S) DISCRIMINATION TOOK PLACE. The form asks for the earliest date the discrimination happened and the most recent one, so have both ready before you begin the particulars.
What is the deadline to file EEOC Form 5?
The form prints no deadline. The EEOC explains time limits and filing steps on its Filing a Charge of Discrimination page at https://www.eeoc.gov/filing-charge-discrimination, so check it before you rely on any date.
What happens if I need more space for the particulars?
Attach extra sheet(s). The form says that if additional paper is needed for THE PARTICULARS ARE, you may attach more sheets. The same section is where you list any respondent beyond the two the form has room for.
Is the EEOC Form 5 charge filed with a state agency too?
The form states that you want the charge filed with both the EEOC and the State or local agency, if any. The top of the form shows both as agencies the charge is presented to, each with a Charge No(s) space.
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