RELEASE OF LIABILITY
- I affirm that the statements that I have made above are accurate and true to the best of my knowledge and belief. I hereby request the assistance of the NAACP DeKalb County Branch in seeking a remedy to the situation described above. I hereby authorize the officers of the NAACP DeKalb County Branch to have access to information and documents, which are relevant to my claim of discrimination described above. I understand that once a referral to a volunteer, community agency, or private attorney has been made, the NAACP DEKALB COUNTY BRANCH WILL NOT BE RESPONSIBLE for handling this matter. In fact, I further understand that by submitting this document, I am agreeing to HOLD the NAACP DEKALB COUNTY BRANCH harmless for any and all damages arising as a result of my case being mishandled, negligently handled, or improperly handled in any way.
- I understand that filing a discrimination complaint with Dekalb NAACP does not mean that the NAACP will be representing me in any legal matter. If I believe I have a discrimination claim, I know I must file a claim with the appropriate State or Federal agency in a timely manner. I understand failure to do so may prevent me from pursuing a claim in a court of law.
- Section 704 (a) of the Civil Rights Act of 1964, (as amended), Section 4 (d) of the Age Discrimination in Employment Act of 1967, (as amended), and various other civil rights laws make it an unlawful employment practice for an employer; employment agency; or labor organization: to discriminate against employees, applicants for employment, member or applicant for membership, because the employee, member or applicant has opposed an unlawful employment practice, made a charge, testified, assisted, or participated in any manner in an investigation, proceeding or hearing.
COMPLETION OF THIS FORM
- Completing this form does not constitute filing an official complaint with a legal authority. At this time the DeKalb County Branch is only seeking information to assist you concerning this complaint. You can mail this information and ALL COPIES of sustaining documents in an envelope marked confidential to:
NAACP DeKalb County Branch 3011 Rainbow Drive, Suite 180A Decatur, Georgia 30034