2. Tell the Economic Justice Unit about Economic Harm

4. Contact Information

6. Name*
7. City*
9. Email Address*
10. Phone Number*
12. What is your preferred contact method?*

    Please include times that you may not be available. Such as requesting a call outside of work hours regarding a complaint against your employer. 

16. Complaint

18. Which of the following are you reporting? (Select all that apply)*

    1. Wage theft
    2. Labor misclassification
    3. Dangerous working conditions
    4. Financial scams
    5. Price gouging
    6. Dangerous rental housing conditions
    7. Labor trafficking
    8. Whistleblowing on county contracts
    9. Environmental contamination
    10. Other
20. Who are you? *

    Please tell us who you are in relation to the problem you are reporting. 

22. Where did it happen? *

    Please tell us where the issue you are reporting occurred.

24. Who did it?*

    Who are you are filing a complaint against? For example, business, employer, contractor, etc. 

26. When did it happen?*

    Please help us understand the times that this occurred. Did it happen once or was this a repeated problem? Please include the date or date ranges. 

28. What happened?*

    Please briefly explain what happened. We will reach out to you if we need further information. 

30. Anything else?*

    Please include anything else you may wish to share that will help us review this case. 

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32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

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