This government document is issued by Labor, Department for use in North Carolina
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https://www.google.com/url?client=internal-element-cse&cx=d6d0fe261fe46d105&q=https://www.labor.nc.gov/retaliatory-employment-discrimination-complaint-form/open&sa=U&ved=2ahUKEwj05468l4-GAxUG5wIHHbx6Cck4ChAWegQIBxAB&usg=AOvVaw2_YYEpyTdXI7vIlYT1vXa5&arm=e&fexp=72519171,72519168