COMPLAINT FORM

 


* are mandatory fields and need to be filled by complainant
PARTICULARS OF COMPLAINANT
1. Title *
2. Surname *
3. First Name *
4. National Identity Card Number *
Please attach a scanned copy of NIC *
5. Address *
6. Occupation *
Kindly provide at least one phone number below:
7. Phone Number - Home
8. Mobile
9. Phone Number - Work
10. Fax
11. Email Address


PARTICULARS OF RESPONDENT(S)/ ALLEGED DISCRIMINATOR(S)
1. Name(s) of person(s) / organisation(s) complained against *
2. Address *
3. Phone Number
4. Fax
5. Email Address
6. Relationship to Complainant (aggrieved person) *


1. Status of Complainant *
(a) On what ground/s do you think you have been discriminated against? Please tick the box that applies *
Age
Ethnic Origin
Political Opinion
Caste
Impairment
Race
Colour
Marital Status
Sex
Creed
Place Of Origin
Sexual Orientation
Criminal Record
(b) Explain exactly what happened and the cirumstances that led to same. (Be brief and precise. Please refer to Section 2 of the Equal Opportunities Act 2008 for particulars.) *
2. Why, according to you, did the respondent(s) act in such a way?
3. How has this problem affected you? What prejudice have you experienced and what would you like us to do following this complaint? *
4. Do you have any witness(es)? *
Yes No
If Yes, please specify their names and respective contact address.
5. Other Institutions *
Have you submitted a complaint against the same person / organisation in relation to the same facts to another institution / court? *
Yes No
If Yes, please specify the name(s) of the institutions and the date(s) of the complaint. (Please attach copies of same) *
Please click on any uploaded document to remove it.
Complaint 1
Complaint 2
Complaint 3
6. Any other relevant information you would like to provide?
7. Other relevant documents
Please attach relevant documents (Maximum 3). If you cannot provide same, kindly inform us where they may be obtained from.
Please click on any uploaded document to remove it.
Document 1
Document 2
Document 3

In case there are more documents, please send by email to eoc@govmu.org,

or by post to:

The Secretary
Equal Opportunities Commission,
1st Floor, Belmont House,
Intendance Street,
Port Louis


Declaration
 
* I hereby declare that I am making this complaint in good faith and that the facts contained therein are true and correct and regarding which I assume full responsibility.

For further information, please contact the Equal Opportunities Commission on 201 1074 / 201 3502.