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EEOC Form 5 (11/09), Charge of Discrimination, page 1
Moderate · 49/100Form Complexity Index

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What this form asks for

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EEOC Form 5, Charge of Discrimination, is the official form used to put an employment discrimination complaint in writing and initiate the EEOC’s administrative process. It identifies the charging party (complainant), the respondent (employer/union/agency/government entity), the protected basis (e.g., race, sex, age, disability, genetic information), and the dates and details of the alleged discrimination. Filing a written charge is generally required for the EEOC to act and may be necessary to preserve the right to bring a private lawsuit under laws such as Title VII, the ADA, the ADEA, and GINA. The charge is typically shared with the respondent and may be dual-filed with a state or local Fair Employment Practices Agency (FEPA) where applicable.
Fillable fields47
Pages2
Sections15
Tables and lists1
Questions that depend on earlier answers11
Form Complexity IndexModerate, 49/100

The AI checks your answers before you download

16 checks built for this form, so a wrong date or a missing answer is caught before anyone else sees it.

Charging Party Name and Title Completeness

Validate that the Charging Party’s name is present and includes an honorific selection where the form requests it (Mr., Ms., Mrs.). This ensures the charge is attributable to an identifiable individual and supports correct correspondence and record matching. If missing or clearly invalid (e.g., only initials or symbols), the submission should be flagged as incomplete and routed for correction.

Charging Party Date of Birth Format and Plausibility

Check that Date of Birth is provided in a valid date format (month/day/year) and represents a plausible past date (not in the future, not unreasonably old). This helps confirm identity and supports age-related jurisdictional analysis (e.g., ADEA relevance) without relying on free-text interpretation. If the date is malformed or implausible, reject or hold the submission for clarification.

Charging Party Address Completeness and ZIP Code Validation

Ensure the Charging Party street address, city, state, and ZIP code are all present and that the state is a valid US state/territory code/name and ZIP is 5 digits (or ZIP+4 if allowed). A complete address is required for notices, service, and agency communications. If any component is missing or the ZIP/state is invalid, the form should be returned for correction or flagged for manual review.

Charging Party Phone Number Format (Primary and Home)

Validate that phone numbers (including area code) contain the required digits and acceptable formatting (e.g., 10-digit NANP for US numbers, allowing separators). This is critical for time-sensitive contact during intake, mediation, and investigation. If phone numbers are missing or invalid, require at least one valid contact number or mark the submission incomplete.

Respondent (Employer/Organization) Identification Required Fields

Confirm that the named respondent organization (employer, labor organization, employment agency, apprenticeship committee, or government agency) has a non-empty name and address (street, city, state, ZIP). The EEOC generally cannot proceed without a clearly identified respondent to notify and investigate. If respondent identity or address is missing, the charge should be considered insufficient and held for follow-up.

Respondent Employee/Member Count Numeric Validation

If 'No. Employees, Members' is provided, validate it is a positive integer within a reasonable range (e.g., 1–10,000,000) and not text. This field can affect coverage thresholds and routing decisions, so it must be interpretable. If non-numeric or negative/zero, flag for correction or treat as unknown rather than ingesting bad data.

And 10 more checks
  • Discrimination Basis Selection (At Least One Box Checked)
  • ‘Other (Specify)’ Required When Other Basis Selected
  • Date(s) Discrimination Took Place: Earliest/Latest Date Validation
  • Chronological Consistency: Earliest Date Must Be On/Before Latest Date
  • Continuing Action Consistency with Date Range
  • Agency Selection and Dual-Filing Consistency (EEOC/FEPA)
  • Agency Charge Number Format (If Provided)
  • Particulars Narrative Required and Minimum Content Check
  • Complainant Signature and Date Required (Sworn/Affirmed Statement)
  • Notary Section Completeness When Notarization Is Required

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How to Fill Out EEOC Form 5 Online for Free in 2026

What the AI walks you through.

  1. Select where the charge is presented (EEOC and/or the state/local FEPA) and enter any agency charge numbers if already assigned.
  2. Enter the charging party’s personal information, including name, date of birth, mailing address, and phone numbers, and confirm you will update contact information if it changes.
  3. Identify the respondent organization(s) you believe discriminated (employer, labor organization, employment agency, apprenticeship committee, or government agency), including name, address, and approximate number of employees/members.
  4. Check the discrimination basis box(es) that apply (e.g., race, color, sex, religion, national origin, retaliation, age, disability, genetic information, or other) and indicate whether it is a continuing action.
  5. Provide the date range of the discrimination (earliest and latest dates) and write the “Particulars” describing what happened, who was involved, and how the actions were discriminatory; attach additional sheets if needed.
  6. Review the statements and certifications (including Privacy Act notice implications and the declaration under penalty of perjury) and confirm the information is true and correct to the best of your knowledge.
  7. Sign and date the charge as the charging party/complainant, and complete notarization only if required by the state or local agency.

Common Mistakes in Completing EEOC Form 5

The ones the AI is built to catch.

Not clearly identifying the correct respondent organization
People often list a supervisor’s name or a worksite location instead of the legal name of the employer, union, agency, or government entity that employed them or controlled the decision. This can delay notice to the respondent, complicate investigation, or require amendments to correct the party. Use the organization’s full legal name (as shown on pay stubs, offer letters, or HR documents) and include the correct address for the entity responsible for the alleged discrimination.
Leaving the respondent address or contact details incomplete
A common error is providing only a city/state, a P.O. box, or an outdated location, which makes it harder for the EEOC/FEPA to serve the charge and communicate with the respondent. Service delays can slow the case and may affect timelines for processing. Provide a complete street address, city, state, and ZIP code for the respondent’s main office or the location that handles HR/legal notices, and double-check it against official sources.
Checking the wrong discrimination basis (or forgetting to check all that apply)
Filers sometimes select only one box (e.g., “Race”) when the facts also involve retaliation, disability, age, sex, national origin, or genetic information, or they check “Other” without specifying. This can narrow the scope of the investigation and may require later amendments to add missing legal theories. Review the list carefully, check every basis supported by your facts, and if using “Other,” clearly specify the protected category in plain language.
Providing vague or inconsistent discrimination dates (earliest/latest/continuing action)
Many people write approximate dates (“sometime in March”) or list only one date when the form asks for earliest and latest dates and whether it is a continuing action. Missing or inconsistent dates can create confusion about filing deadlines and what events are included in the charge. Use the best specific dates you can (month/day/year), list the earliest and latest incidents, and mark “Continuing Action” only when the conduct truly continued over time.
Not selecting (or misunderstanding) dual-filing with EEOC and state/local agency
Some filers overlook the option stating they want the charge filed with both the EEOC and the state/local agency (FEPA), or they assume it happens automatically. This can affect which agency investigates first and may impact procedural rights and timelines. Read the dual-filing statement carefully, indicate your preference clearly, and confirm which agency will handle the charge if you are in a jurisdiction with a FEPA.
Incomplete charging party contact information or failure to update it
People frequently omit an area code, provide only one phone number, or forget to update their address after moving, even though the form states they will advise agencies of changes. Missed mail or calls can lead to missed deadlines, inability to schedule interviews/mediation, or administrative closure. Provide a reliable mailing address, include area codes for all numbers, add both home and mobile if available, and promptly notify the EEOC/FEPA in writing if anything changes.
Missing or incorrect personal identifiers (name title, date of birth)
Filers sometimes forget to indicate Mr./Ms./Mrs., enter a nickname instead of their legal name, or leave the date of birth blank. These details help agencies match records, confirm identity, and apply statutes that depend on age (e.g., ADEA). Use your legal name as it appears on government ID, include the requested title if applicable, and enter your full date of birth accurately.
Not providing enough detail in “THE PARTICULARS” section
A very common mistake is writing a short conclusion (“I was discriminated against”) without describing who did what, when, where, and how it relates to the checked basis(es). Vague particulars can slow intake, lead to requests for clarification, or limit the investigation to an unclear set of allegations. In 2–4 clear paragraphs, include key dates, decision-makers, specific actions (termination, demotion, harassment, failure to accommodate, etc.), comparators if relevant, and the harm suffered; attach extra sheets if needed.
Failing to list additional respondents when more than two are involved
When multiple entities may be responsible (e.g., staffing agency and client company, parent/subsidiary, union and employer), people often name only one and forget to list others under “PARTICULARS.” This can prevent the agency from pursuing all potentially liable parties and may require amendments later. If more than two entities are involved, list each additional respondent in the particulars with full legal names and addresses and explain each entity’s role.
Leaving the number of employees/members blank or guessing wildly
The form asks for “No. Employees, Members,” and filers often skip it or provide an unrealistic estimate. Coverage under certain laws can depend on employer size, and inaccurate information can cause delays while staff verify jurisdiction. If you don’t know the exact number, provide a reasonable estimate and note it is an estimate (e.g., “approx. 75 employees”), based on what you observed or what HR/public filings indicate.
Signature, date, and verification errors (sworn/affirmed requirements)
People sometimes forget to sign, forget to date the form, sign in the wrong place, or submit an unsigned draft, not realizing that Title VII/ADA/GINA charges must be sworn/affirmed and ADEA charges should ordinarily be signed. An unverified or unsigned submission can delay acceptance as a formal charge and may jeopardize timeliness if corrections occur after a deadline. Sign and date where indicated, follow the “under penalty of perjury” language, and complete notarization only if your state/local agency requires it.

Frequently Asked Questions About EEOC Form 5

 

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How does the AI fill out EEOC Form 5?
You answer a few questions in plain words, or upload a document you already have. The AI reads what you give it and puts each answer into the right field of EEOC Form 5, on every page, in seconds. It checks the answers against the form's own rules, and you review and change anything before you download, print or sign.
What happens to my information?
It is encrypted in transit and at rest, and it is never used to train AI.
How complex is EEOC Form 5 to fill out?
EEOC Form 5 has a Form Complexity Index of 49 out of 100, in the moderate tier: 47 fillable fields across 2 pages. Instafill.ai's AI fills it in under a minute, with every field there for you to review before you download.
What is EEOC Form 5 (Charge of Discrimination) used for?
EEOC Form 5 is used to file a formal charge alleging employment discrimination. Filing a charge can preserve your right to sue under certain federal anti-discrimination laws and allows the EEOC (and sometimes a state/local agency) to review the allegations.
Who should fill out this form?
You should complete this form if you believe an employer, union, employment agency, apprenticeship committee, or a state/local government agency discriminated against you or others in employment. The person filing is the “Charging Party.”
Do I have to use EEOC Form 5 to file a charge?
No. The Privacy Act Statement explains it is not mandatory to use this specific form, but the charge must be in writing and should identify you, the organization you are charging, and the actions or policies you are complaining about.
What types of discrimination can I check on the form?
The form lists bases such as race, color, sex, religion, national origin, retaliation, age, disability, genetic information, and “other” (which you can specify). You can check more than one box if multiple bases apply.
What dates should I put for “DATE(S) DISCRIMINATION TOOK PLACE” and what if it happened more than once?
List the earliest and latest dates the discrimination occurred. If it is ongoing, you can indicate “continuing action” and describe the pattern in the “Particulars” section.
What information do I need about the employer or organization I’m charging?
Provide the name and address of the employer/organization and, if known, the number of employees or members. If you are naming more than two organizations, list the additional ones in the “Particulars” section.
What should I write in “THE PARTICULARS ARE” section?
Describe what happened, who was involved, and why you believe it was discrimination (including the protected basis you checked). Include key dates, job titles, locations, and any relevant actions or policies; attach extra sheets if needed.
Can I file the charge with both the EEOC and a state or local agency?
Yes. The form includes an option stating you want the charge filed with both the EEOC and the state or local agency (if any), which is often called “dual-filing” under worksharing arrangements.
What does it mean that a copy of my charge will be sent to the respondent organization?
The Privacy Act Statement explains that a copy of the charge will ordinarily be sent to the employer/organization you are charging. This is part of the process so the respondent can be notified and the agency can investigate or mediate.
Do I have to swear to or affirm the charge, and what is “penalty of perjury”?
For charges under Title VII, the ADA, or GINA, the charge must be sworn to or affirmed (either notarized or as an unsworn declaration under penalty of perjury). “Penalty of perjury” means you are declaring the information is true and you can face legal consequences for knowingly false statements.
When is a notary required on this form?
The form notes “NOTARY – When necessary for State or Local Agency Requirements.” Whether notarization is required can depend on the state or local agency involved, so follow the instructions from the agency handling your charge.
What happens if I don’t provide all the information requested?
The Privacy Act Statement says the EEOC will ordinarily not act without a written charge that identifies the charging party, the respondent, and the actions or policies complained of. However, charges may be clarified or amplified later by amendment.
What should I do if my address or phone number changes after I file?
The form states you will advise the agencies if you change your address or phone number. Update your contact information promptly so you don’t miss notices or deadlines.
What is “Substantial Weight Review” and when do I have to request it?
If a state or local Fair Employment Practices Agency (FEPA) handles your dual-filed charge first, you may request that the EEOC give “Substantial Weight Review” to the FEPA’s final findings. You must request this in writing within 15 days of receiving the FEPA’s findings, or the EEOC will ordinarily adopt the FEPA’s finding and close its file.
What if I’m retaliated against for filing or participating in the process?
The notice explains retaliation is unlawful under several federal statutes and asks you to notify the EEOC or the state/local agency if retaliation occurs. Report any threats, discipline, termination, or other negative actions that you believe are connected to filing or cooperating with the charge.
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Other forms like this one

EEOC forms: U.S. Equal Employment Opportunity Commission (EEOC) Form 453, Recommendation for Recognition, U.S. Equal Employment Opportunity Commission (EEOC) Form 453, Recommendation for Recognition, EEOC Form 5, Charge of Discrimination

discrimination forms: EEOC Form 5, Charge of Discrimination, Pro Se 7, Complaint for Employment Discrimination, Form DOS-2156, New York State Housing Discrimination Disclosure Form

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