Discrimination Complaint Form. Instructions: Please fill out this form completely, in black ink or type.If you would like to file a charge of job discrimination, you must do so either within 300 days from the day you knew about the discrimination. This information packet is designed to help you file an employment discrimination lawsuit in federal court without the help of a trained and licensed attorney. Please submit this form in person, via postal mail, or via email to the Title VI Coordinator at the address below. Your name, address, and phone number. In your complaint, explain in as much detail as possible, how you were discriminated against. Include all relevant names and dates. Describe what happened and why you believe it was housing discrimination. Please be as specific as possible (including dates and names).