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Equal Pay Complaint Form

This complaint form is for Equal Pay. More information about Equal Pay is available at https://labor.illinois.gov/laws-rules/conmed/equalpay

 

EQUAL PAY COMPLAINT FORM

Section 1: Preliminary Questions 

Note: If you did not check at least one of the above boxes describing your claim, please visit the Department of Labor’s complaint forms webpage to file a different complaint.

Section 2: Your Information

Your name and contact information generally will remain confidential unless/until they must be disclosed during the investigation. Confidentiality does not apply when a complaint asserts retaliation, and it may not apply in the event that the Department of Labor receives a request under the Freedom of Information Act that relates to your complaint. 

Please provide the name and contact information of someone who will know how to reach you: 

Section 3: Employer Information

Section 4

A. Fill out this section with information about your pay disparity.  

What were the dates for which you believe you were underpaid due to sex or race?

OR

B. Fill out this section with information for the employee(s) you are aware of who make more for performing the same or substantially similar work in the same county due to race or sex.

OR

If you are African-American and your complaint is based on being paid less than a colleague due to race, what is the race of your colleague making more than you? 

OR

If you are African-American and your complaint is based on being paid less than a colleague due to race, what is the race of your colleague making more than you? 

C. Additional Disparate-Pay Questions.

If YES:

If NO:

Section 5

Section 6:

Such records could include, but are not limited to, each employee’s name, address, occupation, and wages, and/or each position’s scale and benefits and job postings, and/or records required for an Equal Pay Registration Certificate

Such actions could include, but are not limited to, telling a person not to discuss their own or other employees’ wages or benefits, or taking a negative action after a person tried to exercise their own right to equal pay (asking about, disclosing, comparing or otherwise discussing your own or other employees’ wages) or after they aided or encouraged another person to exercise their right to equal pay under the IL EPA.

Such retaliation could be for activity such as failing or refusing to comply with a wage or salary history request, and/or because a person filed any IL EPA charge, started a proceeding or caused one to be started related to an IL EPA right, or gave any information or testified (or were about to do either) in connection with an inquiry or proceeding relating to an IL EPA right.

Section 7: Prior/Other Disputes

If YES,

Do you believe that an employer or their agent violated the IL EPA related to job postings and by failing to include pay scale and benefits in a specific job posting (Pay Transparency), or that an employer that promoted a specific job posting publicly failed to provide notice to its employees within 14 days (Promotional Opportunity?

If YES, please visit the Department of Labor’s separate IL EPA complaint form dedicated to Pay Transparency and Promotional Opportunity violations to file that complaint.

Demographic information

IDOL asks for this voluntary information in order to learn more about the people who file complaints with us. Any information you provide will not be shared or used in relation to your complaint.

Section 8: Certifications

Before submitting this complaint:

By typing my name below I am entering it as my electronic signature and agreeing to the following:

·        I HEREBY CERTIFY that the statements herein, including attachments, are true and accurate to the best of my knowledge and belief.

·        I UNDERSTAND that acceptance of this complaint by the Illinois Department of Labor does not guarantee collection.

·        I ACKNOWLEDGE that any information supplied to the Department may be provided to the employer/principal, the agents of the employer/principal, and other agencies or individuals as the Department deems appropriate.

·        I AGREE that if I move or have changes to my contact information, I will let the Department know right away, and UNDERSTAND that if I do not update my information and/or the Department cannot contact me, my complaint may be dismissed.

·        I AUTHORIZE the Department of Labor to receive any monies paid and to mail such monies to me at my own risk.