F700-200-000 Equal Pay & Opportunities Act Complaint Form 02-2023 Page 1 of 4
What you need to know about filing a
Equal Pay & Opportunities
Act Complaint
Under the Equal Pay and Opportunities Act (EPOA) pay and career advancement opportunities cannot be
based on gender. EPOA prohibits gender pay discrimination and promotes fairness among workers by
addressing business practices that contribute to gender pay gaps. Employees and applicants have different
rights under this law.
Who can file a complaint?
As an employee, you can file a complaint if your employer (or former employer) has:
• Provided you with unequal compensation compared to other employees who are similarly employed,
based on gender.
• Limited or denied career advancement opportunities, based on gender.
• Prohibited you from discussing wages.
• NOT provided you with wage or salary information for your new position after you were offered an
internal transfer or promotion and requested the information. (Applies to employers with 15 or more
employees only)
• NOT provided you with the wage and salary range, benefits, and other compensation on an internal
job posting. (Applies to employers with 15 or more employees only.)
• Retaliated against you for filing a complaint, testifying in an EPOA proceeding, or exercising your
rights under EPOA.
As an applicant, you can file a complaint if an employer with whom you have applied for a job has:
• Sought your wage or salary history.
• Required your wage or salary history meet certain criteria, such as requiring that you made a
minimum salary previously in order to be eligible to apply for a new position.
• Not providing wage or salary range, benefits, and other compensation on a job posting. (Applies to
employers with 15 or more employees only)
! Important: A person is only considered an “applicant” for the specific posting they applied for, not for
every available job of the employer. L&I will investigate complaints filed by applicants who have
applied to a job in good faith with the intent of gaining employment. L&I generally only assesses
damages when an applicant can establish they have suffered a financial loss as a result of a violation
of the law.
For more information, go to: www.Lni.wa.gov/EqualPay
How to file an Equal Pay and Opportunities Act complaint:
• Complete and sign the attached form. Attach a separate sheet of paper if you need more space to
explain your complaint.
• Review the form. Make sure the information is as complete and accurate as possible.
• Save the form. Change the default file name so you can find it easily. If you are using a public or
shared computer, be sure to save it to a safe location like a thumb drive or a secured folder. If that is
not possible, make sure you delete the file after you have completed the next step.
• Submit the form. Submit the form to our secure file upload
. You can use this link to send us
documents, photos, and other supporting information such as pay statements, personnel information,
or employer correspondence (including email and text messages) along with this form.
Or
Mail your complaint form to:
Department of Labor and Industries
Employment Standards
PO Box 44510
Olympia, WA 98504-4510
F700-200-000 Equal Pay & Opportunities Act Complaint Form 02-2023 Page 2 of 4
Or
Bring your complaint form to your nearest L&I office.
! Important: If you move or get a new phone number after filing a complaint, call L&I right away at
1-866-219-7321 to prevent delays in the investigation.
What happens after you file a complaint?:
L&I will review the information you provided to determine if your complaint can be investigated. If so, we will:
• Assign an Industrial Relations Agent to investigate your complaint. Due to the nature of this law, L&I
will need to tell the employer that you filed a complaint.
• If we determine that you are owed money, L&I will attempt to collect the money owed; however, we
cannot guarantee that we can collect it for you.
! Important: You also have the right to file private legal action against an employer for
violations of this law. However, L&I cannot investigate the complaint if a civil complaint is
filed in court.
Continue to next page for form.
F700-200-000 Equal Pay & Opportunities Act Complaint Form 02-2023 Page 3 of 4
For L&I Use Only
CATS #
Employment Standards
360-902-5316 or 1-866-219-7321
Equal Pay & Opportunities
Act Complaint
Section A – My Information
Preferred Language:
English
Spanish
Cambodian
Chinese Traditional
Korean Laotian Vietnamese Other:
Gender
Female
Male
Transgender
Non-binary / Gender Nonconforming
Prefer not to state Other:
Name (As it appears on your ID – First Middle Last Name)
Mailing Address
City
State
Zip Code
Phone Number
Email Address
Secondary Contact Name
Secondary Contact Phone Number
Are you an employee or an applicant?
Employee Applicant
Did you apply to an available position?
Yes No
Have you ever been employed by this
employer?
Yes No
Starting Date with this Employer
Are you still employed with the employer?
Yes No
If “No”, last date employed
Reason for Leaving
Fired Quit Laid Off Don’t Know / Other:
What kind of work do you do?
Section B – Employer Information
Name of Company (Business Name)
Company Contact (Owner, Manager, or Supervisor) Name
Address Where You Worked
State
Zip Code
Company Mailing Address (if different from where you worked)
State
Zip Code
Company Phone Number
Company Email Address
Type of Business (for example: construction, restaurant, etc.)
Is the employer still in business?
Yes No Don’t Know Bankrupt
Continue on Next Page
F700-200-000 Equal Pay & Opportunities Act Complaint Form 02-2023 Page 4 of 4
Section C – Equal Pay and Opportunities Act Complaint
Please attach additional documentation to explain your complaint in more detail.
Select the violation of employee rights that you believe occurred:
Unequal compensation based on gender
Limited or denied career advancement opportunities based on gender
Prohibited wage discussion
Retaliation
Not providing wage or salary range of an internal transfer to a new position or promotion offered by the
employer upon request of the employee
Not providing wage or salary range, benefits, and other compensation on an internal job posting
Select the violations of applicant rights that you believe occurred (mark all that apply):
Seeking wage or salary history
Requiring wage or salary history to meet criteria
Not providing wage or salary range, benefits, and other compensation on a job posting
Section D – Signature
By submitting this form, I am confirming the information provided is accurate and true. I am also
agreeing to cooperate and communicate with my assigned investigator. My name on this form
constitutes my signature.
Signature (Print or Type)
Date