Sample "Workplace Harassment Complaint Letter"

A Workplace Harassment Complaint Letter is a document that can be used by an employee when they become a victim of harassment and want to inform their employer about the incident (or incidents) that has taken place. The purpose of the document is to request the employer to take action regarding the matter.

Filing this letter gives the employees who were harassed an opportunity to protect themselves against assaults and discrimination in their workplace, restore the healthy atmosphere of the workplace, and receive compensation for damaging their mental health.

Some businesses develop their own local forms which they use within their company. Nevertheless, if the company where the employee works do not have a form for this matter, they can find a Sample Workplace Harassment Complaint Letter available for download below.

Generally, this document is supposed to gather information about the participants of the situations, the case of harassment that has occurred (or cases, if it has happened multiple times), information about witnesses of the harassment, and other details. After the employee has completed the form, they are supposed to file it to their supervisor, manager, or Human Resources Department of the company where they work.


Still looking for a particular template? Take a look at the related templates and samples below:

ADVERTISEMENT
ADVERTISEMENT

Download Sample "Workplace Harassment Complaint Letter"

Download PDF

Fill PDF online

Rate (4.3 / 5) 31 votes
Sample Workplace Harassment Complaint Letter
From: ​ J ulia Kelly
723 South Brown Avenue
New York, New York 10023
+1 (999) 330-6060
[​
D ate​
]
To: ​ H uman Resources department
Callister Inc.
8830 Arrowhead Drive
New York, New York 10025
To Whom It May Concern,
I am writing this letter to inform you about the recent events that have created a
hostile atmosphere in my working environment. I feel like I have been subjected to
insults and derogatory remarks by a coworker, Dylan Mills. This is a formal complaint
of harassment that I have been subjected to, and I request early action and proper
investigation of the situation.
I work in the IT department in Callister Inc. and have been employed here for four
years.
The harassment started on [​
D ate​
] when Dylan Mills said that I would not be able to
get a promotion just because I am a woman. The verbal abuse took place on the
premises of the company. I’ve kept a log of his actions:
1. On [​
D ate​
] , Dylan Mills yelled at me because I refused to bring him a cup of
coffee.
2. On [​
D ate​
] , Dylan Mills threatened to steal my phone if I didn’t help him with
his share of work.
3. On [​
D ate​
] , Dylan Mills told me that I deserved to be fired.
4. On [​
D ate​
] , Dylan Mills spread false rumors about me around the office.
©​ ​ ​ ​
T EMPLATEROLLER.COM
Sample Workplace Harassment Complaint Letter
From: ​ J ulia Kelly
723 South Brown Avenue
New York, New York 10023
+1 (999) 330-6060
[​
D ate​
]
To: ​ H uman Resources department
Callister Inc.
8830 Arrowhead Drive
New York, New York 10025
To Whom It May Concern,
I am writing this letter to inform you about the recent events that have created a
hostile atmosphere in my working environment. I feel like I have been subjected to
insults and derogatory remarks by a coworker, Dylan Mills. This is a formal complaint
of harassment that I have been subjected to, and I request early action and proper
investigation of the situation.
I work in the IT department in Callister Inc. and have been employed here for four
years.
The harassment started on [​
D ate​
] when Dylan Mills said that I would not be able to
get a promotion just because I am a woman. The verbal abuse took place on the
premises of the company. I’ve kept a log of his actions:
1. On [​
D ate​
] , Dylan Mills yelled at me because I refused to bring him a cup of
coffee.
2. On [​
D ate​
] , Dylan Mills threatened to steal my phone if I didn’t help him with
his share of work.
3. On [​
D ate​
] , Dylan Mills told me that I deserved to be fired.
4. On [​
D ate​
] , Dylan Mills spread false rumors about me around the office.
©​ ​ ​ ​
T EMPLATEROLLER.COM
Along with the letter, I have attached the statements of witnesses, Melanie Fisher, and
Benjamin Clark, who heard the verbal abuse.
I would like to point out that these repeated instances of harassment have caused me
stress and anxiety, and they have been affecting my performance at work.
I would appreciate it if you could meet me to discuss the issue and take the necessary
action regarding the matter.
Sincerely,
Julia Kelly
[​
S ignature​
]
©​ ​ ​ ​
T EMPLATEROLLER.COM
Page of 2