Texas Employment Discrimination Law–Unsworn Declaration

TEXAS WORKFORCE COMMISSION
CIVIL RIGHTS DIVISION
101 EAST 15TH STREET, RM. 144-T
AUSTIN, TEXAS 78778-0001
UNSWORN DECLARATION
(CIVIL PRACTICE AND REMEDIES CODE, CHAPTER 132)
My name is
;
my date of birth is
;
and my address is
;
(Street)
(City)
(State)
(Zip Code)
(Country)
I declare under penalty of perjury that the foregoing is true and correct.
Executed in
County, State of
, on the
day of
,
.
(Month)
(Year)
(Signature)
Completed forms, inquiries, or corrections to the individual information contained in this form shall be sent to the TWC Civil Rights Division, 101 E 15th St, Rm 144, Austin, TX 78778-0001, (512) 463-2643

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