I COMPLAINT FORM Chapter 378, Employment Practices, Part III Unlawful Suspension, Discharge or Discrimination Due to Work Injury or Drug Testing Instructions You must file a complaint within 30 days of either: (1) the date of the alleged violation, or (2) the date you learned of the alleged violation; or (3) for work injury situations only - the date you were released to return to work. Please completely fill out the WSD-1.378 III Complaint Form. Please type or print legibly. Read all instructi.
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How to fill out the HI WSD-1.378III online
Filling out the HI WSD-1.378III complaint form is a critical step for individuals who believe they have experienced unlawful suspension, discharge, or discrimination due to a work-related injury or drug testing. This guide provides step-by-step instructions to help you complete the form accurately online.
Follow the steps to fill out the HI WSD-1.378III complaint form online.
- Press the ‘Get Form’ button to access the HI WSD-1.378III complaint form and open it in the editor.
- Begin by entering your personal information in items 1 through 8, including your name, address, phone numbers, and employment status. Ensure that all entries are typed or printed legibly.
- Next, provide details about the employer you are filing a complaint against in items 9 through 13. This includes the business name, address, contact information, and the nature of the business.
- In items 14 through 22, complete the complaint information section by indicating the alleged unlawful act, reason for the act, and relevant dates. Ensure to provide specifics about your work injury if applicable.
- In item 23, include a statement of facts where you briefly explain the circumstances of the alleged violation. Be clear and concise, detailing the events you believe warrant your complaint.
- Once you have completed the form, review all information for accuracy. Make sure to sign and date the form in the presence of an authorized representative or a notary public, as required.
- Finally, choose your preferred method of delivery for submitting your complaint form. You can save your changes, download, print, or share the form as needed.
Complete your complaint document online today to ensure your rights are protected.
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