EEOC Deadline Extension Request Form
Submit your request for an extension of an EEOC filing deadline. Please ensure all information is accurate. Submission does not guarantee approval.
Full Name
*
First Name
Last Name
Organization or Employer (if applicable)
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
EEOC Case or Charge Number
*
Original Filing Deadline
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Requested Extension Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Reason for Extension Request
*
Upload Supporting Documents (optional)
Upload a File
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