EEO Incident Report | EC Fennell

EEO Incident Report:

Employee Name:

First

Middle

Last

Position/ Title

Date of Hire required

Name of Alleged Offender:

First

Middle

Last

Position/ Title

Date of Hire required

List the name(s) of the individual(s) involved in the alleged incident.

Please indicate the First and Last name as well as the Department/Other Notes

List the names of anyone who may have witnessed the alleged incident and/or has knowledge of the events that took place

Please indicate the First and Last name as well as the Department/Other Notes

List the names of anyone that may have experienced the same alleged incident.

Please indicate the First and Last name as well as the Department/Other Notes

Have you sought assistance in resolving this complaint from another source?

If yes, please indicate the First and Last name as well as the Department/Other Notes then the date the complaint was issued and result of this complaint

Choose a date required

Incident Description:

Please describe the incident that took place. Include as many details as possible including dates and places where the alleged acts occurred.

How would you like to see the situation resolved?

I have been instructed that I am free to add or change any of the above details, and I am satisfied that the facts stated above are accurate. I declare that the information given above is correct to the best of my knowledge or belief. A willful false statement is subject to disciplinary action.

Your Signature

Indicate Today's Date required

The information collected may be verified with others who may have knowledge or been witness to the acts in question. This company prohibits retaliation against any person who files a complaint or assists in its investigation. This includes intimidation, threats, coercion, or discrimination. Please notify your supervisor or Human Resources manager immediately if any attempt at retaliation is made.

EEO Incident Report Instructions

State & federal anti-discrimination laws prohibit employers from discriminating against employees and applicants on the basis of race, color, sex, religion, and national origin. Larger businesses are also prohibited from discriminating on the basis of age and disability. An employer's best defense against cases of discrimination is responding quickly to any discrimination complaints received. Employers can provide the EEO Incident Report to their workers to gather information on possible discrimination incidents.

Why its Important

Employers are responsible for prohibiting, preventing, investigating, and correcting any unlawful conduct in the workplace. As such, employers must address any allegations of workplace harassment, discrimination, or misconduct in a quick and timely manner. The Equal Employment Opportunity Commission (EEOC) states that in addition to employers taking complaints seriously, they also "must provide timely responses and investigations." Companies that fail to address such issues in a timely fashion could face fines and lawsuits.

Instructions for Use

The EEOC Incident Report Form is to be used to record a complaint of a workplace incident. It may be filled out by the accuser OR by an administrator hearing the complaint and then signed by the person giving the statement. If additional room is needed or statement notes are typed, additional pages can be attached. Once completed, the form can be used to trigger and start an investigation.

When to Use

At the first mention of an act of harassment or discrimination, the employer or manager should provide the EEOC Incident Report Form to the accuser right away. After receiving the Form back from the complainant, the investigating party needs to throughly investigate and resolve the complaint.

Retention Requirements

Under federal law, the minimum retention period for any documentation of an employment action is one year from the date of the action. Federal contractors need to retain those records for at least two years, depending on the laws that apply to them. Some state laws may have extended retention periods when it comes to employment action documents. A completed EEOC Incident Report Form could be considered a corrective action document to support an employment action. Corrective action documents do not have specific retention dates; however, employers should keep them with any corresponding employment action documents for the required retention period.