The declaration option does not require notarization; you need only fill in the blanks with the date and your location (city, state), and sign the declaration. Complete this form to make a report of discrimination.You can make this report whether or not you wish to be involved in an official complaint. The Division of Human Rights complaint form is available at the below link. You may use this form to file and submit your complaint online. This Discrimination Claim Policy and Procedure for the New. Visit our website and download a complaint form. 1) Please fill out this form, answering all of the questions. If you are filling out the form on a computer, please print out the form when you are finished. A charge of discrimination must be filed within one year of the last act of discrimination, or three years, if the claim is for sexual harassment.