Report of Violation
How would you prefer to be contacted?
What is the best time to reach you?
8:00 AM to noon
1:00 PM to 4:00 PM
Workplace/ Business Name:
Workplace/ Business Address:
Is your worksite in Minneapolis?:
Agriculture, Forestry, Fishing and Hunting
Mining, Quarrying, and Oil and Gas Extraction
Transportation and Warehousing
Finance and Insurance
Real Estate and Rental and Leasing
Professional, Scientific, and Technical Services
Management of Companies and Enterprises
Administrative and Support and Waste Management and Remediation Services
Health Care and Social Assistance
Arts, Entertainment, and Recreation
Accommodation and Food Services
Other Services (except Public Administration)
I am a:
Employer/ HR Manager
Briefly describe what happened (who, what, when etc.):
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Send me a copy of my responses
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