EMPLOYEE INFORMATION Please print your name below. Please sign your name in the signature block on this form.Office for Civil Rights Discrimination Complaint Form. Please provide the required information as labeled with an asterisk so that we may contact you to discuss your request. Michigan Legal Help has tools to fill many kinds of forms but we do not cover all areas. You may have a blank form that you need to fill out on your own. A charge of discrimination can be completed through our online system after you submit an online inquiry and we interview you. How do I fill this out? You may also file a complaint using this form. Please be specific in stating the facts concerning your complaint when completing this form.