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Community Relations

NDO@charlottenc.gov

700 Parkwood Road. Charlotte NC, 28203

704.336.5160

Receipt

You will be provided with a Receipt upon submission.

CHARLOTTE-MECKLENBURG COMMUNITY RELATIONS PUBLIC ACCOMMODATIONS / EMPLOYMENT DISCRIMINATION COMPLAINT

The Complainant named below charges the Respondent (s) named below with a violation of the Charlotte Non Discrimination Ordinance (Chapter 12, Articles II, III & IV, of the Charlotte City Code)/Public Accommodations or Employment Protections

Full Name of Aggrieved Person (Complainant):

Full Address

Emergency Contact for Complainant:

Respondent Address:

Basis for Complaint

Address of the subject property:

I swear or affirm that I have read this complaint (including any attachments) and that it is true to the best of my knowledge information or belief.

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