EXEC 50 Form – The EXEC 50 Form is the official California Department of Motor Vehicles (DMV) tool for filing an EEO Discrimination Complaint. This confidential PDF helps individuals report discrimination, harassment, retaliation, or related civil rights issues at the DMV. Whether you are a current or former employee, job applicant, customer, contractor, or vendor, the form provides a straightforward way to seek resolution through the DMV’s Office of Civil Rights and Resolution.
This guide explains everything you need to know about the EXEC 50 Form, including who can use it, how to complete it, submission steps, confidentiality protections, and next steps. All information is drawn directly from the official DMV form and EEO program resources as of 2026.
What Is the EXEC 50 Form?
The EXEC 50 Form (full title: EEO Discrimination Complaint Confidential, REV. 3/2021) is a fillable PDF designed specifically for the California DMV. It allows eligible individuals to report alleged unlawful discrimination, harassment, intimidation, coercion, or retaliation in employment or the provision of DMV services.
The DMV is committed to addressing Equal Employment Opportunity (EEO) and civil rights issues promptly. Using this internal form ensures your complaint reaches the DMV’s dedicated Office of Civil Rights and Resolution for investigation and potential corrective action.
Who Can File an EXEC 50 EEO Discrimination Complaint?
You may use the EXEC 50 Form if you fall into any of these categories and believe you experienced harm at the DMV:
- Current or former DMV employees
- Applicants for employment at the DMV
- Members of the public (customers)
- Independent contractors
- Vendors
The form covers both workplace-related complaints and public-access issues, including ADA-related discrimination.
Protected Bases for Discrimination Under the EXEC 50 Form
The form requires you to identify the protected category (or categories) connected to the alleged harm. California and federal EEO laws protect the following bases:
- Race (including specific race if applicable)
- Religion
- Color
- Sex (including pregnancy, childbirth, breastfeeding, and related conditions)
- Sexual orientation
- Gender, gender identity, and gender expression
- Marital status
- National origin (including language restrictions)
- Ancestry
- Disability (including HIV/AIDS)
- Medical condition (cancer and genetic characteristics)
- Age (40 years or older)
- Military and veteran status
- Political affiliation
- Genetic information
You must clearly explain how the alleged action connects to one or more of these protected bases.
Types of Alleged Harm Covered by the EXEC 50 Form
Section 3 of the form asks you to select the type of harm experienced. Common examples include:
- Failure to appoint or promote
- Denial of reasonable accommodation
- Denial, interference, or retaliation under the Family Medical Leave Act / California Family Rights Act
- Hostile work environment or differential treatment
- Harassment (including sexual harassment)
- Retaliation
- Other (with explanation in Section 5)
Provide the most recent date of the alleged harm in Section 4. The DMV may still take corrective or disciplinary action for incidents that occurred within the past three years.
Step-by-Step: How to Complete the EXEC 50 Form?
The EXEC 50 is a fillable PDF. Follow these steps for a complete and effective submission:
- Section 1 – Complainant Information — Enter your name, contact details, status (employee, applicant, customer, etc.), and supervisor information. Asterisk-marked fields are required.
- Section 2 – Protected Basis — Check all applicable categories and provide additional details where requested.
- Section 3 – Alleged Harm/Action — Select the type of harm.
- Section 4 – Date of Harm/Action — Enter the most recent date.
- Section 5 – Incident — Provide a clear, concise description of what happened, why you believe it was discriminatory, and any supporting examples or names of others treated differently. Use additional sheets if needed.
- Section 6 – Witness Information — List up to two witnesses with contact details and what they can corroborate.
- Section 7 – Respondent Information — Identify up to two people responsible for the alleged action.
- Section 8 – Certification — Sign and date the form under penalty of perjury, certifying that the information is true and correct.
Be factual, specific, and organized. Avoid emotional language—focus on facts and the connection to protected bases.
How to Submit the EXEC 50 Discrimination Complaint?
Email (preferred): Send the completed form to [email protected].
Hard copy request or mailing: Contact your local DMV office manager or call the Office of Civil Rights and Resolution at 916-657-7487 (or California Relay Service at 711). Mail to:
DMV – Office of Civil Rights and Resolution
2415 First Avenue, MS F115
Sacramento, CA 95818
You may file anonymously, but providing contact information helps the investigation. Without it, the DMV’s ability to investigate or resolve the matter may be limited.
Confidentiality of the EXEC 50 Form
The form is explicitly labeled “DISCRIMINATION COMPLAINT CONFIDENTIAL.” The DMV handles complaints discreetly to protect your privacy while conducting a thorough review.
What Happens After You File the EXEC 50 Form?
After submission, the DMV’s Office of Civil Rights and Resolution will review your complaint. They may contact you for additional information or clarification. The department aims to take immediate and appropriate action when discrimination or harassment is confirmed. Retaliation against anyone who files a complaint or participates in an investigation is strictly prohibited.
Alternative Options: Filing with External Agencies
You may also file directly with external civil rights agencies:
- California Civil Rights Department (CRD / formerly DFEH) — calcivilrights.ca.gov
- U.S. Equal Employment Opportunity Commission (EEOC) — eeoc.gov
- State Personnel Board (SPB) — spb.ca.gov (primarily for state employees)
These agencies have their own deadlines (typically three years for CRD employment complaints). Filing with the DMV does not prevent you from pursuing external remedies.
Download the Official EXEC 50 Form PDF
Direct download link (official DMV source):
https://www.dmv.ca.gov/portal/uploads/2025/03/EXEC-50-R3-2021-ASB-WWW.pdf
You can also access the form on the DMV’s dedicated page: EEO Discrimination Complaint Confidential – EXEC 50.
Frequently Asked Questions About the EXEC 50 Form
Is the EXEC 50 Form only for employees?
No. It is available to applicants, employees, former employees, customers, contractors, and vendors.
What is the filing deadline?
There is no strict internal deadline for the DMV form, but corrective action is generally possible within three years of the most recent incident. External agencies have their own time limits.
Can I file anonymously?
Yes, but the investigation may be limited without contact information.
Is legal representation required?
No. You may file on your own.
Where can I get help filling out the form?
Contact the DMV Office of Civil Rights and Resolution at 916-657-7487 or your local DMV office manager.
The EXEC 50 Form remains the primary internal channel for addressing EEO and civil rights concerns at the California DMV. Using this confidential PDF ensures your complaint is handled by the department’s dedicated civil rights team.
For the most current information, always refer to the official DMV EEO Program page and the latest version of the EXEC 50 PDF. If you believe you have experienced discrimination, act promptly and document all relevant details.