Report of Violation
Email (or mailing address, if preferred):
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.):
Has the employer been made aware of the law?
What type of resolution do you seek?
I want to prevent this from re-occurring in the future.
I am owed money.
I deserve to be heard.
All of the above
Information you provide is subject to the Minnesota Government Data Practices Act. You are not required to provide any of the information we ask for; however, if you choose not to provide information, we may not be able to investigate. The information you provide will be kept confidential while we investigate, but it may be shared with others when doing so is necessary for us to investigate. Once an investigation is inactive, information may be available to the public on request, unless otherwise protected by the Minnesota Whistleblower Act.
Send me a copy of my responses
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