Items 1 to 3: complainant and job
Name, home address, home telephone and Social Security number, then the employment type (GSA, former GSA, Federal or non-Federal), program office, office address and telephone, and position title, series and grade.
GSA3467
Formal Complaint of Discrimination
- Agency
- GSA
- Revision
- Rev. 8/1993
- Fillable fields
- 52
- Pages
- 2
- Official source
- GSA form page
- Checked
- October 20, 2026
GSA Form 3467: Formal Complaint of Discrimination
GSA Form 3467, Formal Complaint of Discrimination, is a General Services Administration form, Rev. 8-93, and GSA hosts it in its forms library. The front says to complete it to file a formal complaint of discrimination based on race, color, religion, sex, national origin, age, handicap or reprisal, and to read the information on the back carefully first.
The back explains complaint processing under Title 29 C.F.R. Part 1614. It says the form is for use by an employee of GSA or an applicant for Federal employment, and that the matter is first presented for informal resolution to an Equal Employment Opportunity (EEO) counselor. The front has nine numbered items, from the complainant's details and the bases checked to a description of each allegation, the remedy sought and a signature, plus a block for agency use only.
You can fill it out free in your browser on this page and download the result without an account.
What's on GSA Form 3467
Item 4: basis of the complaint
Check boxes for race, color, religion and national origin with the type stated, sex (female, male, equal pay or sexual harassment), physical or mental handicap, age with date of birth, and reprisal.
Item 5: description
A brief explanation of how the complainant believes they were treated differently. For more than one allegation, the form asks to list each one, give the dates and furnish specific facts for each.
Items 6 and 7: counselor and representative
The EEO counselor's name and telephone number, and the representative's name, title, telephone number and address.
Items 8 and 9: remedy and signature
The remedy sought in the complaint, then the complainant's signature and the date.
Back page: processing information
Nineteen numbered paragraphs on counseling, time limits, investigation, hearings, final decisions, appeals to the EEOC and civil actions.
How to complete GSA Form 3467
- 1
Read the back first
The heading of the form says to read the information on the back carefully before completing it.
- 2
Enter your details
Complete items 1 to 3 with your contact details, the employment type, program office and position title, series and grade.
- 3
Check each basis
Check every basis in item 4 that applies, stating the type where the form asks, and the age in years and date of birth for age.
- 4
Describe each allegation
Explain in item 5 how you believe you were discriminated against. The form says additional blank sheets of paper may be used if necessary.
- 5
Add counselor, representative and remedy
Name the EEO counselor in item 6, any representative in item 7, and the remedy sought in item 8.
- 6
Sign, date and deliver
Sign and date item 9, then deliver it to the officials named in the Notice of Right to File a Discrimination Complaint letter. The space below the line is for agency use only.
Why fill Form GSA3467 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 GSA, not a copy someone retyped
- Works on a phone, tablet or computer
Where it goes and the time limits it prints
Where it goes
The form says the written complaint may be filed with the officials designated in the Notice of Right to File a Discrimination Complaint letter. It is deemed filed on the date received if delivered, or on the date postmarked if addressed to an appropriate official.
Counseling and filing time limits
The form says the matter is presented to an EEO counselor within 45 CALENDAR DAYS of the alleged event or personnel action, and the complaint is filed within 15 CALENDAR DAYS from receipt of the Notice of Right to File letter.
Investigation
The form says the agency is required, under 29 C.F.R. Part 1614, to investigate within 180 calendar days of filing unless both sides agree in writing to extend it by not more than an additional 90 days.
Hearing or final decision
After the Notice of Final Action, the form says a hearing before an EEOC Administrative Judge, or a final decision without a hearing, is requested from the EEO Officer within 30 calendar days.
Appeals and civil actions
The form says appeals go on EEOC Form 573 to the Director, Office of Federal Operations, Equal Employment Opportunity Commission, P.O. Box 19848, 1801 L Street, NW, Washington, DC 20036, and lists when a civil action may be filed.
What the form does not print
The PDF prints no OMB number and no Privacy Act statement. GSA's page lists a current revision date of 08/1993 and no authority or regulation.
Related forms
Who fills out GSA Form 3467?
The back of the form describes who uses it, and the front shows who signs and receives it.
Official sources and the blank
Do it all with indox
No tool matches that search.
Questions about Form GSA3467
Who issues GSA Form 3467?
The footer reads GENERAL SERVICES ADMINISTRATION and GSA FORM 3467 (Rev. 8-93). GSA hosts it in its forms library.
Who is GSA Form 3467 for?
The form says it is for use by an employee of GSA or an applicant for Federal employment who believes they were discriminated against because of race, color, religion, sex, national origin, age (40 and above), handicap and/or reprisal.
What happens before the formal complaint?
The form says the matter is first presented for informal resolution to an EEO counselor within 45 calendar days of the alleged event or the effective date of the personnel action. The counselor then holds a final interview.
How long is there to file GSA Form 3467?
The form says the complaint is filed within 15 CALENDAR DAYS from the date of receipt of the Notice of Right to File a Discrimination Complaint letter from the EEO counselor.
Can someone represent me?
The form says you may have a representative of your own choosing at all stages in the complaint process. Item 7 records their name, title, telephone number and address.
Can a complaint be settled?
The form says voluntary attempts to settle can be made throughout the administrative process, and that a settlement is stated in writing with a copy given to the complainant.
What does the form say about appeals?
It says a final decision may be appealed to the EEOC within 30 calendar days of receipt, on EEOC Form 573, or a civil action may be filed in a United States District Court within 90 days of receiving the final decision.
Does GSA Form 3467 cover Equal Pay Act claims?
Item 4 has an equal pay box under sex. The back says the time limit for a civil action on an Equal Pay Act complaint is two years from the alleged violation, or three years if the violation is willful.