Welcome to the Department of Industrial Relations
DLSE forms - Retaliation/Discrimination
The forms on this server are replicas of the official DLSE forms and are in Adobe's Portable Document Format (PDF). You will need Adobe Acrobat Reader to view or print the forms. To obtain a form by mail, contact your local DLSE office.

Fill-in forms

Forms (related publications are listed separately below)
  • Retaliation/Discrimination Complaint
    • English (acrobat small logoPdf / wordDoc) (DLSE 205) (Rev. 11/2010)
    • Spanish (acrobat small logoPdf / wordDoc) (DLSE 205) (Rev.11/2010)
    • Chinese (acrobat small logoPdf / wordDoc) (DLSE 205) (Rev. 4/2008)
    • Korean (acrobat small logoPdf / ** PLEASE DESCRIBE THIS IMAGE **Doc) (DLSE 205) (Rev. 02/2006)
    • Vietnamese (acrobat small logoPdf / ** PLEASE DESCRIBE THIS IMAGE **Doc) (DLSE 205) (Rev. 02/2006)
    • Tagalog (acrobat small logoPdf / ** PLEASE DESCRIBE THIS IMAGE **Doc) (DLSE 205) (Rev. 02/2006)
Note: If your printer has a problem printing the form, try the "Fit to page" box in the Acrobat Adobe Reader's print function.


Publications (related forms are listed separately above)

  • Retaliation and Discrimination Complaints - A summary of procedures (English) (Rev. 01/2011) - (acrobat small logoPdf / ** PLEASE DESCRIBE THIS IMAGE **Doc / html)
  • Retaliation and discrimination complaints - A summary of procedures (Spanish) (Rev. 01/2011) (acrobat small logoPdf / wordDoc)
  • Retaliation and discrimination complaints - A summary of procedures (Chinese) (Rev. 01/2011) (acrobat small logoPdf / wordDoc)
  • Retaliation and discrimination complaints - A summary of procedures (Korean) (Rev. 01/2011) (acrobat small logoPdf / wordDoc)
  • Participation without retaliation
    • English (Rev. 01/2011) (acrobat small logo Pdf / ** PLEASE DESCRIBE THIS IMAGE **Doc)
    • Spanish (Rev. 01/2011) (acrobat small logoPdf / ** PLEASE DESCRIBE THIS IMAGE **Doc)
    • Korean (Rev. 01/2011) (acrobat small logoPdf / ** PLEASE DESCRIBE THIS IMAGE **Doc)
Note: Additional forms and publications may be added in the future.