The following should be included: •. Charges of discrimination can be filed against employers with four (4) or more employees.Read Instructions carefully before completing this form. 1. Surname(s) - family name(s). Write down your last name(s) like it appears on your passport. 2. All charges of discrimination must be filed within those periods following the last occurrence of discriminatory harm. The employer must provide proof that the applicant will receive the minimum wage and be provided working conditions in accordance with U.S. law. Read Instructions carefully before completing this form. The instructions must be available during completion of this form. If you obtained Schengen visas in the past 3 years, write down their dates of validity. 27.