Date(s) discriminatory action(s) took place: Page 2. A charge of discrimination can be completed through our online system after you submit an online inquiry and we interview you.INSTRUCTIONS: Please print or type all information. The application must be filled out accurately and completely. Please be as specific as possible. Employees wishing to report violations of Equal Employment Opportunity may submit an EEO Complaint Form. Download, Fill In And Print Employment Discrimination Human Rights Complaint Questionnaire - Broward County, Florida Pdf Online Here For Free. Q: Who is required to fill out the Employment Discrimination Human Rights Complaint Questionnaire? When filling out the papers, use the name on your social security card. When. Employment Document Instructions. 1.