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UF Complaint Form / Page 2
IV. DETAILS OF COMPLAINT (Explain your complaint in detail. Add additional pages if necessary.)
a) Describe the specific incident(s) of alleged discrimination, harassment, and/or retaliation. List the times,
dates, location, names and titles of the people involved in the incident(s).
b) State the specific reason(s) why you believe the Respondent(s) discriminated, harassed and/or retaliated against you.
V. WITNESSES (List those witnesses with specific information about your complaint. Add additional pages if necessary.)
Witness #1 (Name) _________
Address (Work) Work Phone
Address (Home) Home Phone
Mobile Phone
Witness’ Status: Student Faculty TEAMS USPS OPS _________________
What specific information can this witness provide
_____________________________________________________________________________________________________________________________________
Witness #2 (Name & Title) ______
Address (Work) Work Phone
Address (Home) Home Phone
Mobile Phone
Witness’ Status: Student Faculty TEAMS USPS OPS _________________
What specific information can this witness provide
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source: hr.ufl.edu
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