Form MCHR-27 at a glance
What it is: MCHR-27 is the Charge of Discrimination form of the Missouri Department of Labor and Industrial Relations Commission on Human Rights and EEOC.
Notary: NOTARY - (When necessary to meet State and Local Requirements): I swear or affirm that I have read the charge and that it is true to the best of my knowledge, information and belief.
A filled-in Form MCHR-27 example: a complainant names her employer

How to fill out Form MCHR-27, box by box
Your Name, Date of Birth, Home Telephone and address
The Employer, Labor Organization or Agency who discriminated

List the Employer, Labor Organization, Employment Agency, Apprenticeship Committee, State or Local Government Agency who discriminated against you (if more than one, list each).
Enter the Name, No. of Employees/Members and Telephone No. (Include Area Code).
Enter the Street Address and City, State, and ZIP Code.
Enter the Name, No. of Employees/Members, Telephone No. (Include Area Code), Street Address and City, State, and ZIP Code.
Cause of Discrimination based on
Charge filed with both the EEOC and the Missouri Commission, Signature of Complainant

I want this charge filed with both the EEOC and the Missouri Commission on Human Rights. I will advise the agencies if I change my address or telephone number and I will cooperate fully with them in the processing of my charge in accordance with their procedures.
Sign to declare under penalty of perjury that "the foregoing is true and correct."
Sign at Charging Party (Signature) and add the Date.
Only under NOTARY (When necessary to meet State and Local Requirements): Signature of Complainant, then Subscribed and sworn to before me this date (Day, month, and Year).
More rules for Form MCHR-27
Enter Charge Number.
This form is affected by the Privacy Act of 1974; see Privacy Act Statement before completing this form.
The Particulars Are (If additional space is needed, attach extra sheet(s)).
Sources
[1] Form MCHR-27 (12-13), Charge of Discrimination, Missouri Commission on Human Rights (the Official source link on this page).


