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COMPLAINTPROCEDUREFORALLEGATIONSOFDISCRIMINATION

OfficeofDiversityandAffirmativeActionUpdatedMarchof2014

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ComplaintProcedureforAllegationsofDiscrimination1

StatementofPrinciplesStony Brook University (including Stony BrookMedicine, Long Island StateVeteransHome,andallotherStonyBrookUniversityfacilitiesandprograms),referredtoasStonyBrookor theUniversity,hasa longstanding commitment toequalemploymentandeducational opportunity, and environments that foster respect, dignity, fairness, andequity.StonyBrookiscommittedtocreatingandmaintainingworkplace,educational,andrecreational environments that are safe and accessible, and free of all formsofdiscrimination.In continuing StonyBrooks effort to seek equity in education and employment, andconsistent with Federal and State antidiscrimination legislation, the University hasadoptedacomplaintprocedureforthepromptandeffective investigationofallegationsofdiscriminationonthebasisofrace,color,creed,nationalorethnicorigin,religion,age,sex, sexual orientation,gender identity,disability,military status,genetic information,criminalconviction,domesticviolencevictimstatus,and/ormaritalstatus.Harassmentonthebasisofanyof theaboveprotectedcategoriesisdiscriminatoryharassmentandisaform of discrimination. StonyBrook shallmake reasonable efforts to investigate andaddressinstancesofdiscriminationofwhichitbecomesaware,evenintheabsenceofacomplaintorcomplainantcooperation.ApplicabilityofProcedureThisprocedure applies to all complaints allegingdiscrimination,which include sexualharassment, sexual assault and sexual violence, against employees, students or thirdparties.2Thisprocedureisintendedtobalancetherightsofthosebringingcomplaintsofdiscrimination(theComplainant)withthoseagainstwhomsuchclaimsarebrought(theRespondent).Throughouttheseprocedures,thepartiesshallrefertotheComplainantandtheRespondentinvolvedinthecomplaint.1Thisdocumentisprovidedforinformationalpurposesonly.Itisnotintendedtobeinterpretedorrelieduponaslegaladvice.Anyoneseekingorrequiringlegaladviceshouldconsultanattorney.2AthirdpartyreferstoanyoneoutsidetheUniversitycommunity,includingbutnotlimitedto,guests,visitors,vendors,andvolunteers.

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ThisproceduremaybeutilizediftheComplainantorRespondentisaStonyBrookstudent,employee or third party, if the alleged incident(s) took place at aUniversity facility,program,oractivity. Employee grievance procedures established through negotiatedcontracts, academicgrievancereviewcommittees,studentdisciplinarygrievanceboards,andanyotherproceduresdefinedbycontractwillcontinuetooperateasbefore.ExternalAgenciesThisproceduredoesnotdepriveaComplainantof the right to filea complaint withoutside enforcementagencies, such as theNewYork StateDivision ofHumanRights,the United States Equal EmploymentOpportunity Commission, the Office for CivilRightsof theUnitedStatesDepartmentofEducationandtheOfficeofFederalContractComplianceoftheUnitedStatesDepartmentofLabor.AComplainantmayfileachargeofdiscrimination withtheappropriatestateand/orfederalenforcementagenciesatanypointintheprocess,subjecttoapplicabletimelimitations. Itisimportanttonotethatfilinganinternalcomplaintpursuanttothisproceduredoesnotextendthetimelimitsestablishedbystateandfederalenforcement agencies.AlistofstateandfederalenforcementagenciesarelistedinAppendixA.Uponfilingwithanexternalagency,theStonyBrookinternalcomplaintmaybereferredtotheOfficeofGeneralCounselforreview,defenseor,ifdeemedappropriate,mediation,conciliation,orsettlementwiththeexternalagency,orsuchotheractionsasmaybeintheinterestsoftheUniversity,includingtheterminationoftheinternalprocess.JurisdictionoftheOfficeofDiversityandAffirmativeActionisnotExclusiveTheUniversitywillinvestigateallegedactsofdiscriminationofwhich itbecomesaware.BasedoninformationreceivedbytheOfficeofDiversityandAffirmativeAction(referredtoasODAA),theODAADirectorordesigneemayexercisehis/herowndiscretionandinitiate an investigation in the absence of a complaint. Depending on the circumstances,allegationsofdiscriminationmayalsobereferredtoand/or investigatedbyODAAandotherUniversityoffices,includingEmployeeandLaborRelations(LaborRelations)andStudentAffairs.If at any time during the course of investigating a complaint theODAADirector ordesignee determines that a complaint is not within the jurisdiction of the office, thecomplaintandtheComplainantshallbereferredtotheappropriateofficeandthemattershall be considered concluded by ODAA. The ODAA Director or designee maydeterminethataspecificcomplaintis of such a seriousnature that themattermustbereferred immediately to the appropriate University office. The University PoliceDepartmentmayalsobecomeinvolvedifcriminalconductisimplicated.

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TheFollowingShouldbeReportedtoODAAforInvestigationDiscriminationAllallegedviolationsofStonyBrookpolicy,whichprohibitsdiscriminationonthebasisofrace,color,creed,nationalorethnicorigin,religion,age,sex,sexualorientation,genderidentity, disability, military status, genetic information, criminal conviction, domesticviolencevictimstatus,and/ormaritalstatus,shouldbereportedforinvestigation.DiscriminatoryHarassmentDiscriminatoryharassmentisaformofdiscrimination,whichisprohibitedandshouldbereported.Discriminatoryharassmentisimproperconducttowardaparticularindividual,individuals,orgroupsonthebasisofoneormoreofthecategoriesindicatedabove,whichissufficientlysevereorpervasivethatithasthepurposeand/oreffectof:

Creatinganintimidating,hostile,oroffensiveworkoreducationalenvironmentforindividualsand/orgroups;or

Unreasonably interfering with the work, academic performance, livingenvironment,personal security, orparticipation in anyUniversitysponsoredactivityofindividualsand/orgroups.

SexualHarassment Sexualharassmentisaformofdiscriminationbasedonsex,whichisprohibitedandshouldbereported.Sexualharassmentencompassesunwelcome,genderbasedverbalorphysicalconduct, such as unwelcome sexual advances, unwelcome requests for sexual favors,requests for sexual favors in exchange for some benefit, and/or unwelcome verbal orphysicalconductofasexualnature.Sexualharassmentoccurswhen:

Submission to such conduct ismade either explicitly or implicitly a term orconditionofanyindividualsemploymentoreducation;or

Submissiontoorrejectionofsuchbehaviorbyanindividualisusedasthebasisforemploymentoreducationaldecisionsaffectingtheindividual;or

Abehavior is sufficiently severe,persistentorpervasive to interferewith anindividuals work or educational performance, or creates an intimidating,hostile,oroffensiveworkoreducationalenvironment.

Examplesofbehaviorsthatmayrisetothelevelofsexualharassmentinclude,butarenotlimitedto,thefollowing:

Physicalassault; Directorimpliedthreatsthatsubmissiontosexualadvanceswillbeacondition

ofemployment,work status,promotion,grades,work references,or lettersofrecommendation;and

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Apatternofbehavior that isunwelcome,andsevereorpervasive,resulting inunreasonable interference with the work, educational or recreationalenvironment or the creation of a hostile, intimidating or offensive work,educationalorrecreationalenvironment,may include,but isnot limitedtothefollowing:

o Commentsofasexualnature;o Sexuallyexplicitstatements,questions,jokes,oranecdotes;o Unnecessary or undesirable touching, patting, hugging, kissing, or

brushingagainstanindividualsbody;o Remarks of a sexual nature about an individuals clothing, body, or

speculationsaboutsexualexperiences;o Persistent,unwantedattemptstochangeaprofessionalrelationshiptoan

amorousrelationship;o Subtlepropositions forsexualactivityordirectpropositionsofasexual

nature;o Uninvitedletters,emailmessages,textmessages,telephonecalls,orother

correspondencereferringtoordepictingsexualactivities;and/oro Anyoftheabovecarriedoutviasocialmedia.

SexualAssaultSexualassaultisdefinedasaphysicalsexualactoractscommittedagainstapersonwithouttheir consent. Sexual assault is an extreme form of sexual harassment. Sexual assaultincludeswhatiscommonlyknownasrape,whetherforcibleornonforcible,daterapeandacquaintancerape.SexualViolenceSexualviolenceisdefinedasanyotherformofaphysicalsexualactperpetratedagainstanindividualwithouttheirconsentorwhenapersonisincapableofgivingconsent.TitleIXComplaintsAllindividualsreportingactsofsexdiscrimination,sexualharassment,orsexualviolencewillbe informedbyODAAof theiroptionsand resources, consistentwithTitle IXafederal statute that prohibits discrimination on the basis of sex.Complainantswill beprovided a list of available resources, including counseling, local rape crisis centerinformation,medical services,police services,and stateand/or federalagencies for thefilingof external complaints.Complainantswill alsobe advisedof their right to file acomplaintwithlocallawenforcementagencies.

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Stony Brook will comply with law enforcement requests for cooperation, which mayrequire theODAAandotherUniversityoffices to temporarilysuspend the factfindingaspectofaTitleIXrelatedinvestigationwhilethelawenforcementagencyisintheprocessof gathering evidence. Stony Brookwill promptly resume its investigation as soon asnotifiedbythelawenforcementagencythatitiscompletedtheevidencegatheringprocess.As necessary, Stony Brook will implement appropriate interim steps during the lawenforcementagencysinvestigationtoprovideforthesafetyoftheComplainantandtheUniversitycommunity,andtoavoidretaliation.ODAAstaffmayexplaintheavailabilityofinterimmeasuresduringitsinvestigation,asappropriate.Inthecaseofaninvestigationofpossiblesexualharassment,Complainantsmay be informed as to where to obtain counseling, psychological, medical and/orpsychiatricservices.StudentComplainantsmaybeinformedaboutinterimmeasuresthatcan be taken if the Respondent lives on campus and/or attends classes with theComplainant.ODAAstaffwillexplainthatsuchmeasuresshouldnotdisproportionatelyaffecttheComplainantandhe/sheshouldbereferredtoStudentAffairsforassistancewithmakingsucharrangements.RoleoftheStaffoftheOfficeofDiversityandAffirmativeActionThe ODAA is a neutral factfinding office. Professional staff members are trained ininvestigatingcomplaintsandareavailabletoassistwithfilingacomplaint.Investigationswillbeconductedinapromptandeffectivemanner.Bothpartieswillhavetheopportunityto offer evidence to be considered. ODAA does not represent either party, but doesadvocateonbehalfoftheUniversitysprinciplesofequalopportunity,nondiscriminationandequity.TheODAAanditsDirectorreporttotheUniversitysTitleIXCoordinator,whoisalsotheSenior Director for Title IX and Risk Management (referred to as the Title IXCoordinator),andreportsdirectlytotheUniversityPresident.TheTitleIXCoordinatormayparticipate inODAA functions,whichareset forth in thisprocedure.TheTitle IXCoordinatormaybecontactedat:OfficeofDiversityandAffirmativeActionStonyBrookUniversity201AdministrationBuildingStonyBrook,NY117940251Phone:6316326280

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ConflictofInterestTheODAAshallreceiveanyinformationconcerninganyfactorsthatcouldprejudiceanobjective evaluation of the evidence. In theevent thata conflictof interestarises, theUniversitywilltakenecessarymeasurestoensurethattheinvestigationis thoroughandimpartial. These measures may include reassignment of the investigation to otherinvestigatorswithappropriate experienceandtraining.IfastaffmemberofODAAorthe Ti t l e IX Coordina tor istheRespondent, themattermaybereferredtothePresidentorhis/herdesignee.IfthePresidentistheRespondent,theODAAwillreferthecomplainttotheOfficeofGeneralCounsel.ConfidentialityTheODAA staffwill conduct its investigation in a confidentialmanner to the extentpracticableand/orpermittedby law.Note,however, that theODAAs factfindingmayalsobeutilizedbyotheroffices,includingLaborRelations(asconsistentwiththecollectivebargainingagreements).Thepartiesandwitnessesareexpectedtocooperatefullyintheinvestigation,andmaintainandpreservetheconfidentialityoftheinvestigation.FilingaComplaintTheODAAstaffmayreceivecomplaintsfromstudents,employeesorthirdparties,andinquiries,reports,andrequestsforconsultationandcounseling.AcomplaintmaybefiledwitheithertheODAAortheTitleIXCoordinator(seepage12forcontactinformation).ODAAstaffshouldbeconsultedtodiscusstheviabilityofpursuingacomplaintagainstathirdparty.Thisprocedureassumesthatawrittencomplaintwillbesubmitted.However,complaintsmaybefiledorally.TimeframeOrdinarily,complaintsshouldbefiledwithinninety(90)daysafterthelastactofallegeddiscrimination occurred. In instances involving a student complaint against a facultymemberchargingdiscriminationthatoccurredinthecontextofasubordinatesupervisoracademicrelationship(e.g.,teaching,advising,thesisordissertationsupervision,coaching,clinicalmedicalsupervision),thetimeperiodmaybeextendeduntilninety(90)daysafterthe student is no longer under the faculty members academic or clinical medicalsupervision.

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SupervisoryResponsibilityComplaints or concerns that are reported to or act(s)/conduct that is observed by anadministrator,managerorsupervisorinvolvinganallegedactofdiscrimination, shouldbe promptly referred toeither theODAAor theTitle IXCoordinator forappropriateaction.Allotheremployeesarealsoencouragedtomakesuchreportstotheirsupervisor,theODAAortheTitleIXCoordinator.RetaliationRetaliationagainstan employee, studentoranywitnesswhoparticipates inanODAAinvestigation pursuant to this procedure is prohibited. Retaliation is also prohibitedagainst any individual who files a sex discrimination complaint under Title IX orparticipatesinacomplaintinvestigationinanyway.Anysubstantiatedactofretaliationmay result insanctionsorotherdisciplinaryactionas coveredbycollectivebargainingagreements,and/orapplicableUniversitypolicies.ProceduresforInvestigatingComplaintsComplaintConsultation&ReviewThe length of time for the consultation will vary depending on factors such as thecomplexityof thesituation,officeworkload,orwhetherthesituationinvolvesactualorimminent loss of employment or academic standing, potential physical harm, or anongoing relationship between the parties. In a telephone conversation or inpersonappointment,astaffmemberwill:

Receivecomplaintsofallegeddiscrimination; Discussthefactsofasituationandhelptheindividualidentifytheproblem(s); AssisttheComplainantintheuseoftheComplaintIntakeForm; Determine if the ODAA is the appropriate University office to address the

allegation(s); Inform the individual of the ways in which the ODAA approaches its

investigativeprocesses; AdviseanindividualofalternateavailableUniversityresourcesandexternal

options;and ProvidetheComplainantwithinformationaboutthevariousinternalandexternal

mechanismswithwhichthecomplaintmaybefiled.

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ExpectationsThe Universitys review procedures are not designed to replicate an external judicialprocess.Consequently:

ComplainantsandRespondentsareexpectedtomeetwithODAAstaffasneededandrequested;

Duringanyportionof theprocedures, thepartiesshallbe proh ib i t ed f rom us ing audioorvideotapingdevices;

Advocates and representatives of a Complainant or a Respondent may notparticipateatanymeetingconvenedbyODAA;

Respondents and Complainants are expected to communicate with ODAAdirectly,notthroughlegalcounsel,otherintermediaries,orpersonsaccompanyingtheparties;

TheODAAmayprovidethepartieswithperiodicupdates,asdeemedappropriateand/ornecessary;

Asappropriate,theODAAwillprovidethepartieswithwrittennoticeofwhetherthecomplainthasbeensubstantiated.

IntakeInterviewTheODAAstaffwillaskaComplainanttoparticipate inan initial intake interview, inwhichtheComplainantwillbe:

Asked tocompleteaComplaint IntakeForm(theComplainantmaybeasked tohavethiscompletedpriortotheintakeinterview)(seeAppendixB);

Interviewedsothattheallegationsmaybeclearlystated; Asked to provide information about witnesses and other possibly aggrieved

persons; AdvisedofODAAsinvestigativeprocedures; Referred to another University office if the complaint does not fall within

ODAAsjurisdiction; AdvisedoftheUniversityspolicyagainstretaliation; Advised of the extent to which ODAA can maintain confidentiality in the

investigativeprocess;and Advised of the option to file a complaint with external federaland/orstate

investigativeagenciesatanytime.

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AftertheIntakeInterviewThe ODAA staff willdetermine whether a complaint merits further review. If it isdeterminedthataninvestigationisnecessary,theODAAwillcommencetheinvestigationin a prompt and effectivemanner, pursuant to the jurisdiction requirements outlinedabove.AninvestigationisstartedoncetheODAAstaffhasdeterminedthatacomplaintmeritsfurtherinvestigation,oriftheallegationinvolvessexualharassment,sexualassaultoranyformofsexualviolence.Duringthisinvestigation,theODAAstaffwill:

ReasonablyinformtheRespondentoftheComplainantsallegation(s); ReviewallUniversityrecordsthatconcernthecomplaint; Interviewwitnesses; ReviewstatementsprovidedbytheComplainantandtheRespondent; Reviewotherrelevantevidence;and Takeallreasonablestepsnecessarytocompletetheinvestigationwithin90calendar

days after receipt of the complaint. ODAA may extend this deadline for areasonableperiodoftime,asneeded.ODAAwillinformthepartiesifanextensionisneeded.

EvidenceStandardTheevidentiarystandardappliedinallODAAinvestigationsisthepreponderanceoftheevidence.Inotherwords,thequestionthatmustbeposedandanswerediswhetheritismore likely than not that any alleged event(s) occurred. If the answer is yes, thecomplainthasbeensubstantiated.Inreachingitsfindings,theODAAstaffshallevaluateallfactsandevidence,andconsidertheseverityandfrequencyoftheallegedact(s). RespondentsRefusaltoCooperateIftheRespondentisanemployeewhorefusestocooperateand/orrespondinatimelymanner,ODAAmayforegocompletionofaninvestigationandreferthemattertoLaborRelations,asappropriate,ortheofficemaytakeanyotheractionitdeemsnecessaryandappropriate to address the situation. If the Respondent is a student who refuses tocooperateand/orrespondinatimelymanner,ODAA mayforegocompletion of an investigation and refer the matter to the University Community Standards Office and/orStudentAffairs, as appropriate. ComplainantsInactionorDecisionNottoCooperateDuring an investigation, ifaComplainantdeclines to cooperatewithODAAor if theofficedeterminesthattheComplainantno longerwishestopursueacomplaint,ODAAmay consider the matter closed and may take no further action, with appropriatenotification to theparties.ODAA also reserves the right to continue its investigation,regardlessofComplainantcooperationorinvolvement.

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ComplaintsWithdrawalofComplaintIf aComplainantwithdrawsa complaint, suchadecision should be communicated inwriting to theODAA staff.TheUniversitymay, nevertheless, chose to investigate theallegation(s).AttheConclusionoftheInvestigationThe ODAA staff issues a written statement indicating whether the complaint wassubstantiated.Ifthecomplaintwassubstantiated:

(i) For Students the ODAA may refer the matter to the UniversityCommunityStandardsOffice forappropriateaction(ifany)under theapplicableStudentConductCode.

(ii) For Employees (including student employees) not in a CollectiveBargainingUnitinconsultationwithLaborRelationsandtheOfficeofGeneralCounsel,appropriateadministrativeactionmaybetaken.

(iii) ForEmployeesinCollectiveBargainingUnitstheODAAmayrefer

the matter to Labor Relations for investigation under the applicablecollectivebargainingagreement.

Uponconcludingitsinvestigation,ODAAwillassurethatstepswillbetakentopreventdiscrimination and harassment, to prevent the reoccurrence of discrimination andharassment,andtoremedythediscriminatoryeffectsontheComplainant(s)andothers,ifappropriate.AppealThereisnorightofappealfromthefindingsofaninvestigationconductedbyODAA.

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Tofileacomplaintpursuanttothisprocedure,requestassistanceorfor

additionalinformation,pleasecontact:

MarjolieLeonardTitleIXCoordinator

InterimDirectorforTitleIXandRiskManagementOfficeofDiversityandAffirmativeAction

201AdministrationBuildingStonyBrook,NY117940251

Email:Marjolie.Leonard@stonybrook.eduTitleIX@stonybrook.eduPhone:6316326280

OfficeofDiversityandAffirmativeAction(ODAA)WestCampusOffice

201AdministrationBuildingStonyBrook,NY117940251

Email:ODAA@stonybrook.eduPhone:6316326280Fax:6316329428

OfficeofDiversityandAffirmativeAction(ODAA)UniversityHospitalSatelliteOfficebyappointmentonly

Level5,Room624Phone:6316326280Fax:6316329428

Foradditionalinformation,visittheODAAwebsiteat:www.stonybrook.edu/diversity

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AppendixA

ExternalEnforcementAgenciesNewYorkStateDivisionofHumanRightsStateHeadquartersNewYorkStateDivisionofHumanRightsOneFordhamPlaza4thFloorBronx,NewYork10458Tel:(718)7418400Email:InfoBronx@dhr.ny.gov

LongIslandDistrictNewYorkStateDivisionofHumanRights175FultonAvenue,Suite404Hempstead,NewYork11550Tel:(516)5381360Email:InfoLongIsland@hdr.ny.gov

NewYorkStateDivisionofHumanRightsStateOfficeBuildingVeteransMemorialBuilding250VeteransMemorialHighwaySuite2B49Hauppauge,NewYork11788Tel:(631)9526434

Email:InfoLongIsland@hdr.ny.govOfficeofSexualHarassmentNewYorkStateDivisionofHumanRightsOfficeofSexualHarassment55HansonPlace,Room900Brooklyn,NewYork11217Tel:(718)7222060

OfficeofFederalContractComplianceProgramsNewYorkDistrictOffice26FederalPlaza,Room36116NewYork,NewYork102780002Tel:(212)2647742Fax:(212)2648166

EqualEmploymentOpportunityCommissionNewYorkDistrictOffice33WhitehallStreet,5thFloorNewYork,NewYork10004Tel:(800)6694000Fax:(212)3363790OfficeofCivilRightsNationalHeadquartersLyndonBainesJohnson(LBJ)U.S.DepartmentofEducationBuilding400MarylandAve,SWWashington,DC20202Tel:(202)4010418Fax:(202)2607465OfficeofCivilRightsNewYorkU.S.DepartmentofEducationFinancialSquare32OldSlip,25thFloorNewYork,NewYork10005Tel:(646)4283906Fax:(646)428390

AppendixBComplaintIntakeForm

CASE#

STONYBROOKUNIVERSITY,OFFICEOFDIVERSITY&AFFIRMATIVEACTIONComplaintIntake&InformationSheet

Name: Date: Address: DayTelephone#: EveningTelephone#: Cell#:

Maywecontactyouatwork?Yes No StateEmployee

Student(undergraduate) Student(graduate)1. Pleaseindicateyour:

DateofBirth: Sex: ReligiousAffiliation: Race/Ethnicity: MaritalStatus: Jobtitle: DateofHire:

Highestlevelofeducationcompleted: Departmentinwhichyouwork: SupervisorsnameandJobtitle:

2. Nameandtitleofthepersonthatallegedlydiscriminatedagainstyou:

Theirstatus: Student GA/TA Faculty Staff

3. Whatwasdonetoyouthatyoufeelwasunfair? (checkallthatapply):

DeniedFairGrade DeniedAccesstoProgram DeniedAccommodation DeniedEqualPay DeniedEqualTreatment FailedtoHire DeniedTraining DeniedPromotion LaidYouOff TerminatedYou ForcedYourRetirement/Resignation Subjectedyoutoahostileworkenvironment Other:

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4.Wereyougivenareason(s)forwhatwasdonetoyou? Ifso,whatreason(s)?5. Whatdoyouthinkistherealreason(s)? Discrimination* becauseof..

Creed/ReligiousBelief Gender Age NationalOrigin/Ancestry Race/Color Physical/MentalCondition/Disability Pregnancy Marital Status Sexual Orientation OpposedDiscrimination Sexual Harassment Other(explain):

*Note: If youdontbelieve the reasonwasdiscrimination,please inform theAffirmativeAction/EEO

Specialist.6.Disabilitycases: Whatisthenatureofyourdisability?

7.Didyouaskforanaccommodation?Yes No Ifso,towhom?_ Whatwastheaccommodationsought?

8.Original(first)dateofdiscrimination: 9.Mostrecentdateofdiscrimination:

10.Haveyoufiledacomplaintwithanyotheragency,court,ordept.regardingthismatter?Yes No

Ifso,where? 11.Describeeverythingthathappenedtoyouthatyoufeelwasdiscriminatory.Includeeachevent,the

date(s),namesand titlesofeveryoneinvolved. Attachadditionalpagesifnecessary.12.Didyoucomplain?Yes No Ifso,towhom?

13.Whendidyoucomplain? 14. Wasanyoneelsetreatedthesamewaythatyouwere?

Name JobTitle Race/Ethnicity Age Gender

15. Didanyonewitnessthetreatmentthatyouweresubjectedto?

Name JobTitle TelephoneNo. Whatdidtheywitness?16.Areyouaunionmember?Yes No Ifso,didyoufileagrievancewithyourunion?

CSEA PEF UUP Council#82 GSEU NYSCOBA

17.Whatisyourcurrentsalary? 18.Arethereanydocumentsthatcansupportyourcase? Ifso,whatarethey,anddoyouhavethem?

19.Whathaveyoulostasaresultofwhathappenedtoyou?(salary,benefits,etc.)

20.Whatreasonableremedyareyoulookingfor?

I affirm that I have read the above allegation(s) and that it is (they are) true to the best ofmyknowledge.TheOfficeofDiversityandAffirmativeActionandtheComplainantshallagreetokeepallinformationgathered relative to allegationsofdiscriminationin confidence to the extentpracticableorallowablebylaw. However,withtheconsentoftheComplainant,theOfficeofDiversityandAffirmativeActionmayproviderelevantinformationtotheappropriateUniversitystaffwhennecessary.

Ihavebeenadvised that it isaviolationofStateandFederalstatutes to retaliateagainstan individualbecausetheyhavefiledadiscriminationcomplaint. IfIamsubjectedtoanyadverseactionthatIfeelmayberetaliatory,IwillpromptlyreportsuchtotheOfficeofDiversityandAffirmativeAction.

I have been further advised that the filing of an internal complaintwith the Office of Diversity andAffirmativeActionisnotawaiverofmyrighttofileaformalcomplaintofunlawfuldiscriminationwiththeNewYorkStateDivisionofHumanRights,theEqualEmploymentOpportunityCommission(EEOC),theFederalcourts,ortheStatecourts.

Inaddition,Iamadvisedthatthefilingofan internalcomplaintdoesnotstopthestatuteof limitationsfor filing external complaintswithEEOC, theNYSDivisionofHumanRights, litigation,or any otheragencyhearingsuchcomplaints. Iamaware that should I choose to fileaverifiedcomplaintwithanoutsideagency,suchacomplaintmustbefiledwithEEOCwithin180daysof theallegedincident,andwiththeStateDivisionofHumanRightswithin365daysoftheallegedincident.2

Date ComplainantsSignatureRevised 1/04 ForOfficeUse:

2 Please note that this policy and the information contained in it does not constitute legal advice. If you require legal advice, consult an attorney.

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Forma De Reclamo

Numero de caso _

La Universidad de Stony Brook, La oficina de Diversidad y Accin Afirmativa

Fo rmu l ario d e Info rmaci n y Reclamo

Nombre: Fecha:_

Direccin: Numero de telefono(dia):_ Numero de telefono (noche):_ Podemos contactarlo en el trabajo? S No

Empleado del estado Estudiante (no graduado) Estudiante (graduado)

1. Por favor indique su: Fecha de nacimento: Sexo:

Religin:

Raza/Etnica: Estado civil:

Ttulo de trabajo: Fecha que fue empleado: Grado de educacin completado: Departamento en que trabaja:

Nombre de supervisor y el ttulo:

2. Nombre(s) y ttulo de la persona(s) que presuntamente a discriminado contra usted.

Ellos son: Estudiante Asistente graduado/asistente de professor Facultad

3. Que le hicieron que usted cree fue injusto? ( marke todo que aplique):

Negado grado justo Negado acceso a programs Negado comodidad Negado pago justo Negado tratamiento justo Negado empleo Negado entrenamiento Negado Promocion Lo han despedido Han terminado su empleo Forcado su reginacin/ jubilacin Lo han sometido a un ambiente de trabajo hostil Otra razn:

4. Le a dado usted razn para justificar lo que le han hecho.? Cul fue la razn? 5. Cul cree usted que es la razon verdadera? Discriminacin a causa de ..

Su creencia religiosa/credo

Gnero

Edad Nacion de origen/ascendencia Raza/Color Condicion fsica/mental/discapacidad Embarazo Estado civil Orentacon sexual Discriminacin Opuesta Acoso sexual Otra razn (explique):

*Nota: Si usted no cree que la razn es discriminacin, por favor informe al especialista de accin

afirmativa.

6. Caso de impedimentos: Que es su impedimento? 7. Pido usted ajustes razonables? S No Cual fue la ajuste razonable ?

8. La fecha del primero incidente de discriminacin:

9. La fecha del incidente de discriminacin mas reciente :

10. Ha llenado otro reclamacion con otra agencia, corte, o departamento en referencia de este mismo caso?

11. Describa todo lo que ocuro que usted siente fue discriminacin. Incluya todo evento, fecha, nombres y ttulos de todos los participantes :

12. Puso una reclamacion? A quien? 13. Cuando puso la reclamacion? 14. Alguien mas fue tratado de la misma manera que usted fue tratado?

Nombre Ttulo Raza/ Etnica Edad Gnero

15. Alguien fue testigo de este tratamiento al que usted fue sujeto ?

Nombre Ttulo Numbero de Telefono De que fueron testigo?

16. Es miembro de una unin? S No Lleno un reclamo con la unin? S No

CSEA PEF UUP Council 82 GSEU NYCOBA

17. Cual es su salario?

18. Tiene documentos que apoye su caso? S No Que son y los tiene usted ?

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19. Que a perdido como resultado de lo que le a pasado? ( salario, benecifios, etc.) 20. Que remedio razonable busca?

Yo afirmo que a leido los alegatos arriba y que a mi mejor conocimento todo es cierto. La Oficina de Diversidad y Accin Afirmativa y el reclamante estan de acuerdo que todo la informacin reunida es relativa a los alegatos de discriminacin y es en confianza. Sin embargo, con el consentimiento del reclamante la Oficina de Diversidad y Accin Afimativa, puede dar informacin relativa al reclamo al personal de la Universidad cuando sea necessario.

Estoy aconsejado que es una infraccin Estatal y Federal tomar represalias contra un individuo por la razn que ellos han llenado una reclamo de discriminacin. Si yo soy subjetido a una accin (medidas) adversa que yo siento es represalia, yo le informare a la Oficina de Diversidad y Accin Afirmativa.

Me han aconsejado que al llenar una reclamacin interna con la Oficina de Diversidad y Accin Afimativa no renuncio mi derecho a llenar un reclamo formal de descriminacin ilegal con la Division de Derechos Humanos del el Estado de Nueva York, La Comision de Igualdad de Oportunidades de Empleo, corte federal, o corte de estado.

Adems, me han aconsejado que llenando un reclamo interno no afecta el estatutes de limitacion exponido dentro de la ley federal y del estado. Estoy enterado que si lleno una reclamo verificada con una agencia externa, tengo 180 dias dentro la ocurencia del presunto incidente para llenar un reclamo con el EEOC y tengo 365 dias del presunto incident para llenar un reclamo con La Division de los Derechos Humanos en el Estado de Nueva York.

Fecha Firma de el reclamante

Para uso de la oficina:

* Observe por favor que esta pliza y la informacin contenida no constitute asesoramiento leagal. Si usted requiere asesoramiento legal, consulte a un abogado.

Revisado 3/04

AppendixCComplaintProcessatAGlance

Intake Process

Mediation/ Resolution

Investigation Review Records

Fact Finding Meetings

Interview Witnesses

Determination

Unsubstantiated

No Probable Cause

Substantiated Probable

Cause

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proceduresappendexes