[DC GOVERNMENT] Application_Form_Complaint:-Fair_Criminal_Record

Application Form Complaint: Fair Criminal Record Screening

Employers may not ask about arrests, criminal accusations, criminal convictions or other criminal background-related questions on employment application forms.* Alleged violations of the law can be filed using this Type A complaint form. If any of the previously mentioned criminal background-related questions were asked during the interview process, or a job offer was revoked in violation of law after an inquiry into criminal convictions was made, please complete the Type B complaint form

1. Jurisdiction

The alleged violation meets the following criteria:

It occurred in the District of Columbia or is related to an employment position in the District of Columbia;

It occurred on or after the law’s effective date of December 17, 2014; and

The employer has 11 or more employees.

2. Complainant Information

Preferred Name

Telephone

How do you prefer we contact you?

Phone

Mail(using address provided)

What language do you prefer to communicate in?

Do you require a reasonable accommodation? If so, please explain.

2. Incident Infomation

Date Alleged Violation Was Discovered

Employer Name

Employer Telephone

Type of Application:

Online

Paper Application

Other

If Other

Job Position (if specified)

Please provide us below with an image of the application or a link to the website where the application can be found (optional but highly recommended). Your complaint at OHR will be processed more quickly if you provide this information.

Upload an image, photo or PDF of the application.

Click Here to Upload

Provide a hyperlink to the website where the application appears.

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