"Voluntary Withdrawal Request Form" - Illinois

Voluntary Withdrawal Request Form is a legal document that was released by the Illinois Department of Human Rights - a government authority operating within Illinois.

Form Details:

  • Released on May 1, 2012;
  • The latest edition currently provided by the Illinois Department of Human Rights;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Illinois Department of Human Rights.

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Download "Voluntary Withdrawal Request Form" - Illinois

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VOLUNTARY WITHDRAWAL REQUEST FORM
RESPONDENT: ______________________________
COMPLAINANT: ______________________________
I hereby request to withdraw my charge filed against the above named Respondent with the
Illinois Department of Human Rights (Charge Number ____________________). Withdrawal is
being made of my own free will, without pressure from any organization or individual.
If I am withdrawing this charge because I have reached a settlement with the Respondent, which
has not been approved by both the Department and the Human Rights Commission, those
agencies cannot enforce that settlement.
I understand that the withdrawal of my charge is effective upon receipt by the Department of my
signed and dated Voluntary Withdrawal Request Form. The Department will then issue an Order
of Closure as soon as administratively feasible and will not otherwise delay processing.
_______________________________________
Signature
_______________________________________
Date
NOTE:
The Department of Human Rights will not accept or process a Voluntary
Withdrawal Request Form with different, additional, edited or changed text from
its standard form above.
#6 – C/N/P/R
05/12
VOLUNTARY WITHDRAWAL REQUEST FORM
RESPONDENT: ______________________________
COMPLAINANT: ______________________________
I hereby request to withdraw my charge filed against the above named Respondent with the
Illinois Department of Human Rights (Charge Number ____________________). Withdrawal is
being made of my own free will, without pressure from any organization or individual.
If I am withdrawing this charge because I have reached a settlement with the Respondent, which
has not been approved by both the Department and the Human Rights Commission, those
agencies cannot enforce that settlement.
I understand that the withdrawal of my charge is effective upon receipt by the Department of my
signed and dated Voluntary Withdrawal Request Form. The Department will then issue an Order
of Closure as soon as administratively feasible and will not otherwise delay processing.
_______________________________________
Signature
_______________________________________
Date
NOTE:
The Department of Human Rights will not accept or process a Voluntary
Withdrawal Request Form with different, additional, edited or changed text from
its standard form above.
#6 – C/N/P/R
05/12