Complaint sample. PDF. Complaint fill in. PDF.Field 1: Fill in the county in which the action is brought. Be consistent with other forms. To start the process of reporting discrimination, please call 311 or (212) 416-0197 and ask for the NYC Commission on Human Rights or send us an inquiry. Intheblanks form required for any matter originating and electronically filed in Supreme or Surrogate's Courts in Richmond County. Each complaint must recite the name of each complainant and respondent in a caption in the following form: Sample Title 47 Complaint Format. Verified complaint in writing. All forms on this page will open in a new window. • assist the Complainant in the use of the complaint form to define the charge.