DLSE forms - Retaliation/Discrimination

The forms on this server are replicas of the official DLSE forms. You will need Adobe Acrobat Reader to view or print the forms. To obtain a form by mail, contact your local DLSE office.

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Forms (related publications are listed separately below)

• Retaliation/Discrimination Complaint
  • DLSE Form RCI 1 - English (RCI 1) (Rev. 11/2012)
  • DLSE Form RCI 1 - Spanish (Rev.11/2012)
  • DLSE Form RCI 1 - Chinese (Rev. 11/2012)
  • DLSE Form RCI 1 - Korean (Rev. 11/2012)
  • DLSE Form RCI 1 - Vietnamese (Rev. 11/2012)
  • DLSE Form RCI 1 - Tagalog (Rev.11/2012)

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) (html)
• Retaliation and discrimination complaints - A summary of procedures (Spanish) (Rev. 01/2011)
• Retaliation and discrimination complaints - A summary of procedures (Chinese) (Rev. 01/2011)
• Retaliation and discrimination complaints - A summary of procedures (Korean) (Rev. 01/2011)

• Participation without retaliation
  • English (Rev. 02/2013)
  • Spanish (Rev. 02/2013)
  • Korean (Rev. 02/2013)

Note:

Additional forms and publications may be added in the future.