Fair Credit in Employment Intake Form

Employment Intake Questionnaire
Credit Information

The new Fair Credit in Employment Act of 2016 prohibits employers in the District of Columbia from asking for or relying on the credit information of a current or potential employee in making employment decisions (exceptions apply). Credit Information is a new protected trait in the workplace under the DC Human Rights Act of 1977 and is defined as “any written, oral, or other communication of information bearing on an employee’s credit worthiness , credit standing, credit capacity, or credit history.” For more information call the Office of Human Rights or visit ohr.dc.gov/page/faircredit. Fields with asterisks (*) are required.

Complainant Information
Incident Information
Attorney or Counsel Information (optional)
Incident Information

The following steps help us to ensure we have the proper information about your housing application experience and assists us in preparing for our intake interview with you. Please complete each step below to the best of your ability before submitting this complaint to us (required boxes are marked with **).

Step 1: Credit Information Inquiry
Current Position or Position Applied for
Step 2: Witnesses
Step 3: Other Factors
DC Government Employees or Applicants Only

DC government employees must consult an agency EEO counselor within 180 days of the alleged discriminatory act prior to filing with OHR, unless the employee is alleging sexual harassment. OHR cannot process a complaint from a current or former DC Government employee unless (1) the employee has received an exit letter from an agency EEO Counselor; (2) 21 days have passed since the matter was called to attention of the agency’s EEO Counselor and no exit letter has been written; or (3) the employee is alleging sexual harassment.

You have filed an informal complaint with an agency assigned EEO Officer/Counselor

Additional Narrative Information

I want to file a charge of discrimination, and I authorize OHR to look into the discrimination I described above. I understand the agency must give the employer, union, or employment agency that I accuse of discrimination information about the charge, including my name. I acknowledge OHR will also investigate additional claims using other civil rights laws in the District ofColumbia.

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