This version of the form is not currently in use and is provided for reference only. Download this version of Form F416-011-000 for the current year.
This is a legal form that was released by the Washington State Department of Labor and Industries - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.
Q: What is Form F416-011-000?
A: Form F416-011-000 is a Dosh Discrimination Complaint form in Washington.
Q: What is Dosh?
A: Dosh stands for the Department of Labor & Industries' Division of Occupational Safety and Health.
Q: What is the purpose of the Form F416-011-000?
A: The purpose of the Form F416-011-000 is to file a complaint if you believe you have been discriminated against for participating in safety and health activities at your workplace.
Q: Who can file a discrimination complaint using this form?
A: Any employee in Washington who believes they have been discriminated against for participating in safety and health activities at their workplace can file a discrimination complaint using this form.
Q: What information do I need to provide on the form?
A: You will need to provide your personal information, the name of your employer, a description of the discrimination you experienced, and any supporting documentation or evidence.
Q: Is there a deadline for filing the form?
A: Yes, you must file the form within 30 days of the alleged discrimination.
Q: What happens after I submit the form?
A: After you submit the form, the Department of Labor and Industries will review your complaint and may conduct an investigation.
Q: What are the possible outcomes of the investigation?
A: The Department of Labor and Industries may find that discrimination occurred and take appropriate action, such as ordering the employer to stop the discrimination or imposing penalties.
Q: Can I be retaliated against for filing a discrimination complaint?
A: No, it is illegal for an employer to retaliate against an employee for filing a discrimination complaint.
Form Details:
Download a fillable version of Form F416-011-000 by clicking the link below or browse more documents and templates provided by the Washington State Department of Labor and Industries.