Civil Rights Complaint Form We protect the civil rights of individuals belonging to a protected class, including those who may be discriminated against on the basis of their actual or perceived race; color; national origin; ancestry; sex (including pregnancy, childbirth, and related medical conditions); sexual orientation; gender identity or expression; disability; age; citizenship or immigration status; genetic information; or status as a person living with AIDS/HIV, or person who is homeless. Please note that filing this complaint does not constitute a criminal complaint. To file a criminal complaint, you must contact the Rhode Island State Police or your local police department. By filling out this form, our Office can: Investigate complaints Bring civil enforcement actions for injunctive relief to protect individuals who have been subjected to bias-motivated actual or threatened violence, damage or destruction of property, or trespass on property Please fill out and submit this form: If you believe your civil rights have been violated and would like this Office to investigate your claim or file a lawsuit on your behalf To report a hate crime To report incidents of police misconduct or excessive use of force by police An asterisk (*) below denotes a required field. This web form utilizes a CAPTCHA function to prevent spam submissions. If you are experiencing difficulty using this form, please call 401-274-4400 to submit a civil rights complaint. Your Information Name First Last Email Phone Address Street Address Address 2 City/Town State/Province - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon ZIP/Postal Code Person/entity you are filing complaint about (if known) Name of Person/Entity Email Phone Address Address Address 2 City/Town State/Province - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon ZIP/Postal Code Nature of the alleged violation Please check specific area(s) that apply to your complaint Race/color Religious liberties Gender, Gender identity or expression Sex Genetic information Person living with AIDS/HIV Military/Veteran status Educational opportunities Institutionalized person rights Excessive use of force by police National origin/immigration status/ancestry LGBTQ status Age Status as a domestic abuse victim Person who is homeless Disability rights Credit/lending opportunities Police misconduct Other area not listed above (Please describe below.) Please clearly describe the violation(s) you allege Include as much information as possible, including the date, place, nature of incident, and contact information for any witnesses (please attach copies of supporting documentation, but do not send original documents to our Office) Attach additional documents One file only.10 MB limit.Allowed types: gif, jpg, jpeg, txt, pdf, doc, docx, ppt, pptx, xls, xlsx, mp3, mp4, zip. Do you believe that the violation of civil rights described in this complaint is part of, or results from, a policy, pattern, or practice on the part of the person or entity named above? If so, please describe the policy, pattern, or practice in detail and identify others who you believe were subjected to the same or similar treatment and when (if you know) this similar treatment occurred Are you represented by an attorney in this matter? Yes No Please provide the name, address, and phone number of your attorney Name Address Street Address Address 2 City/Town State/Province - None -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon ZIP/Postal Code Phone Have you filed a lawsuit concerning this matter? Yes No Please provide the case name, docket number, court in which the case was brought, and the status of the case Case name Docket number Court in which the case was brought Status of the complaint Have you filed a complaint about this matter with any other federal, state, or government agency? Yes No Please list the agency, contact person, phone number, and status of the complaint Agency Contact person Phone Status of complaint Thank you for submitting this form. Our Office will carefully consider the information you have provided to determine whether a violation of the state civil rights laws, a hate crime, or police misconduct or excessive force may have occurred and, if so, whether this Office or another agency has enforcement authority to assist you. Please check the boxes and sign below to certify that you have read and understand the following: If you believe a crime has been committed, contact the Rhode Island State Police or your local police department immediately. Filing this complaint does NOT constitute a criminal complaint. To file a criminal complaint, you MUST contact the Rhode Island State Police or your local police department. The Rhode Island Attorney General’s office cannot provide independent legal advice or individual representation. The Attorney General’s Office has limited civil rights enforcement authority, as described at the top of this form. In some cases, hiring a private attorney may be necessary to pursue your legal claim. The Rhode Island Attorney General’s Office can only provide referrals to the private bar through the Rhode Island Bar Association’s Lawyer Referral Service. SUBMITTING A COMPLAINT TO THIS OFFICE HAS NO EFFECT ON ANY STATUTE OF LIMITATIONS THAT MIGHT APPLY TO ANY CLAIM YOU MAY HAVE. BY SUBMITTING THIS COMPLAINT YOU HAVE NOT COMMENCED A LAWSUIT OR OTHER LEGAL PROCEEDING, AND THIS OFFICE HAS NOT INITIATED A SUIT OR PROCEEDING ON YOUR BEHALF. 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