Equal Opportunities Commission

Complaint Form

Note: Fields marked with an asterisk (*) are required.

Particulars of aggrieved person

* I would like to lodge a complaint of discrimination under the following Discrimination Ordinance(s):

Disability

Family Status

Race

Sex (including Sex, Marital Status, Pregnancy & Breastfeeding Discrimination)

Title

* English Name

Chinese name

* ID card / Passport no.

First four digits (without the English alphabet)

* Contacts

Phone no.

Email address

If an email address is provided, an acknowledgement with a copy of the completed form generated by the system will be sent to the email address upon form submission. If a representative is authorised (APR), the acknowledgement will be sent to the APR instead.

Correspondence address

* Preferred mode of written communication

Representative:

I would like to appoint an authorised representative.

Particulars of authorised representative

I hereby appoint the following person as my representative to assist me in handling my complaint.

Title

Name

Chinese name

Reason(s) to appoint an authorised representative

Relationship

eg. Friend, Legal Representative, Relatives, Employer-Employee, Colleagues, Spouse

* Contacts

Phone no.

Email address

If an email address is provided, an acknowledgement with a copy of the completed form generated by the system will be sent to the email address upon form submission.

Correspondence address

Preferred mode of written communication

Particulars of respondent

* Name of respondent

Phone no.

Email address

Correspondence address

The complaint

* Please state your allegation(s). (Please include any concerned person(s), date, time, location, incident and effects on you.)

The information provided by the aggrieved person in this complaint form is true to the best of the person's knowledge.

Any supporting documents?

(Up to 3 attachments, only files in pdf, jpg, jpeg, png and gif formats can be accepted. File size of each attachment should not exceed 4 MB.)

Choose file for File 1

Choose file for File 2

Choose file for File 3

Any special requests?

(e.g. Mail should be sent to me by registered mail)

Authorisation

* Please check the boxes:

I understand that by submitting this complaint form, my statement of complaint and/or supplementary information may be passed to the respondent for information and response where necessary.

I authorise the Equal Opportunities Commission to obtain information from the respondent to facilitate the handling of my complaint(s) lodged under the Sex/ Disability/ Family Status/ Race Discrimination Ordinance.