Appendix 12


AGREEMENT TO EXTEND 180 DAYS FOR COMPLAINT INVESTIGATION


Bureau Equal Opportunity Office
Address
 

Dear Equal Opportunity Officer:

This is in reference to the complaint of discrimination I filed against the Department of the Interior, Bureau/Office on (date), docket number (XXX-XX-XXX) .

I have received notice that the investigation of my complaint has not yet been completed and that it has been one hundred and eighty (180) days since my complaint was filed. I understand that I now have the right to request a hearing before an Equal Employment Opportunity Commission (EEOC), Administrative Judge (AJ), or I may allow the Bureau/Office an additional ninety (90) days to complete the investigation of my complaint. Pursuant to regulations at 29 C.F.R. 1614.108 (e):

[ ] I agree to a ninety (90) day extension for the Bureau/Office to complete the investigation of my complaint.

 

[ ] I do not agree to a 90-day extension to complete the investigation of my complaint. I am requesting a hearing by the EEOC, or in a mixed-case, a decision by the Director, OEO. Please advice me of the appropriate EEOC Field Office to which I should send my request.



                                                                            Sincerely,
 
 

                                                                            
                                                                            Complainant's Name                             Date