Caption
The district and division of the United States District Court, the plaintiffs and defendants, the case number to be filled in by the Clerk's Office, and a jury trial yes or no box.
Pro Se 7
Complaint for Employment Discrimination
- Agency
- U.S. Courts
- Revision
- Rev. 12/16
- Fillable fields
- 99
- Pages
- 6
- Official source
- U.S. Courts form page
- Checked
- October 20, 2026
Pro Se 7: Complaint for Employment Discrimination
Pro Se 7, Complaint for Employment Discrimination, is a pleading form from the U.S. Courts for an employment discrimination case in a United States district court. It is one of the Civil Pro Se Forms, which the U.S. Courts page says are limited to types of cases often filed in federal courts by people who represent themselves or who may not have much experience in federal courts.
The 6-page form asks for the parties and the place of employment, the laws the case is brought under, a short and plain statement of the claim, the charge filed with the Equal Employment Opportunity Commission, the relief requested, and a signed certification under Federal Rule of Civil Procedure 11. The printed form is marked Rev. 12/16, and the page lists it as effective on December 1, 2016, as a PDF and a Word file.
The page says no form provides legal advice or substitutes for having or consulting a lawyer. This page explains the form in plain words and is not legal advice. You can fill it out free in your browser on this page and download the result without an account.
What's on Pro Se 7
Section I: The parties
Contact details for each plaintiff, up to four defendants with an individual's job or title if known, and the address where the plaintiff sought employment or was employed.
Section II: Basis for jurisdiction
Check all that apply: Title VII (race, color, gender, religion, national origin), the Age Discrimination in Employment Act, the Americans with Disabilities Act, or other federal, state, city or county law.
Section III: Statement of claim
Boxes for the conduct (such as failure to hire, termination, failure to promote, failure to accommodate a disability, unequal terms, retaliation), the dates, whether it is continuing, the basis of discrimination, and the facts.
Section IV: Exhaustion of remedies
The date a charge was filed with the EEOC or an EEO counselor, whether the EEOC issued a Notice of Right to Sue letter and when it was received, and, for age claims only, whether 60 days have passed.
Sections V and VI: Relief and certification
The damages or other relief requested, with amounts and their basis, then the Rule 11 certification and signatures for a party without an attorney or for an attorney.
How to fill out Pro Se 7
- 1
Fill in the caption
Enter the district and division and the full name of each party. The form says the case number is filled in by the Clerk's Office, and it asks for one box for a jury trial, yes or no.
- 2
List the defendants and the workplace
The form asks for each defendant, whether an individual, a government agency, an organization or a corporation, and for an individual's job or title if known. Additional pages may be attached.
- 3
Write a short and plain statement
The form says not to make legal arguments, to state how each defendant was involved and what each did, with dates and places, and to number each claim in a separate paragraph.
- 4
Attach the EEOC papers
The form says to attach a copy of a Notice of Right to Sue letter from the EEOC if one was received. It also says a copy of the charge filed with the EEOC or a state or city human rights division may be attached.
- 5
Leave out private details
The U.S. Courts page cites Federal Rule of Civil Procedure 5.2: a filing may include only the last four digits of a Social Security or financial account number, the year of birth, and a minor's initials.
- 6
Sign and date Section VI
The signer certifies under Rule 11 that the complaint is not presented for an improper purpose and that its claims and facts have support, then adds the date and printed name.
Why fill Form Pro Se 7 on indox
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
- Fill the form right in your browser, no software to install
- Free to fill and free to download, with no account
- The official blank straight from the U.S. Courts, not a copy someone retyped
- Works on a phone, tablet or computer
Court, EEOC notes and timing
Court
The form is captioned for a United States District Court, district and division. The page says to consult the rules and caselaw that govern in the court where the pleading is filed.
EEOC notes on the form
The form's notes say a Title VII or ADA suit in federal district court first needs a Notice of Right to Sue letter from the EEOC, an ADEA suit first needs a charge filed with the EEOC, and only grounds raised in the EEOC charge can be considered under the federal statutes.
Fees
The form and its page do not state a filing fee. The U.S. Courts also publishes Fee Waiver Application Forms, such as AO 239, an application to proceed in district court without prepaying fees or costs.
Timing
The page says the forms give no guidance on when pleadings, claims or defenses have to be raised or who has to be sued, and that some have to be raised within a certain period of time.
A lawyer
The page says that if you are not a lawyer and are suing or have been sued, it is best to have or consult a lawyer if possible.
Formats
The U.S. Courts page offers Pro Se 7 as a PDF and as a Word document.
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Who uses Pro Se 7?
The form and its U.S. Courts page describe these filers.
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Questions about Form Pro Se 7
Is Pro Se 7 legal advice?
No. The U.S. Courts page says no form provides legal advice or substitutes for having or consulting a lawyer, and that following a form does not guarantee a pleading is legally or factually correct or sufficient.
What does Pro Se 7 say about the EEOC?
Its notes say a Title VII or Americans with Disabilities Act suit in federal district court first needs a Notice of Right to Sue letter from the EEOC, and an Age Discrimination in Employment Act suit first needs a charge filed with the EEOC.
Can the complaint add grounds that were not in the EEOC charge?
The form's note in Section III says only those grounds raised in the charge filed with the EEOC can be considered by the federal district court under the federal employment discrimination statutes.
Who answers the 60-day question?
The form says only litigants alleging age discrimination answer Section IV.C, which asks whether 60 days or more, or less than 60 days, have passed since the age discrimination charge was filed with the EEOC.
Who fills in the case number?
The form says the case number is filled in by the Clerk's Office.
What personal details does the complaint leave out?
The U.S. Courts page says Rule 5.2 limits a filing to the last four digits of a Social Security, taxpayer identification or financial account number, the year of someone's birth, and a minor's initials.
Does Pro Se 7 say when to file?
No. The page says the forms give no guidance on timing or on who has to be sued, and that some claims have to be raised within a certain period of time.