ATTACHMENT - Guide to Templates

The attached templates use pull down menus which are not linked to each other. For example, if the user selects the CFPA as the appropriate statute, the user should select the following from the subsequent pull down menus: 210 days to Kick-Out, the partner agencies should be the Consumer Financial Protection Bureau/DOJ Civil Frauds Division, the regulation should be 29 CFR Part 1985.

The following table is designed to help users ensure that their selection of a Kick-Out statute is consistent with the proper Kick-Out period, Partner Agency, and Regulation.

Statute	Days to Kick Out	Partner Agency	Regulation
ACA	210	Employee Benefits Security Administration	29 CFR Part 1984
CFPA	210	Consumer Financial Protection Bureau/DOJ Civil Frauds Division	29 CFR Part 1985
CPSIA	210	Consumer Product Safety Commission	29 CFR Part 1983
FSMA	210	Food and Drug Administration	29 CFR Part 1987
ERA	365	Nuclear Regulatory Commission/Department of Energy	29 CFR Part 24
FRSA	210	Federal Railroad Administration	29 CFR Part 1982
MAP21	210	National Highway Traffic Safety Administration	29 CFR Part 1988
NTSSA	210	Federal Transit Administration	29 CFR Part 1982
SPA	210	U.S. Coast Guard	29 CFR Part 1986
STAA	210	Federal Motor Carrier Safety Administration	29 CFR Part 1978
SOX	180	Securities and Exchange Commission/ Consumer Financial Protection Bureau/ DOJ Civil Frauds Division	29 CFR Part 1980

Attachment 1 - Notification of Suspension

[Complainant’s/Complainant’s Attorney Name]
[Address]
[City, State, Zip]

RE: [Company Name] / [Complainant] / Case No. [1-2345-02-001]

Dear: [Complainant/Complainant’s Attorney]:

On [Date], you (Complainant) filed a complaint with the Occupational Safety and Health Administration (“OSHA”) under the Choose an item. Over Choose an item. days have passed since you filed this complaint. Under the Act, if the Secretary has not issued a final decision within Choose an item. days of the filing of the complaint, and there is no showing that such delay is due to the bad faith of the complainant, the complainant may bring a de novo action in federal district court. Choose an item.

You notified this office by letter dated (DATE) that you intended to file the above-captioned case in federal court. As a result of your electing to proceed with your case in federal court, we are suspending our investigation of your case. Within seven days after filing a complaint in federal court, please provide OSHA with a copy of the file-stamped complaint. The file-stamped complaint may be sent to OSHA by email. The date of filing with OSHA is the postmark date or the email date of the submission to OSHA. If you have not provided OSHA with a copy of your complaint within 30 days of receipt of this letter, please submit a status update to this office at that time.

If at any time you have questions or require further information regarding employee or employer rights and responsibilities under Choose an item. or any other whistleblower statute administered by OSHA, please contact this office.

Sincerely,

(RSI Name)

Regional Supervisory Investigator

cc: Respondent/Respondent’s Attorney

ATTACHMENT 2 - RECEIPT OF COMPLAINT

[Complainant’s/Complainant’s Attorney Name]
[Address]
[City, State, Zip]

RE: [Company Name] / [Complainant] / Case No. [1-2345-02-001]

Dear: [Complainant/Complainant’s Attorney]:

On [Date], you (Complainant) filed a complaint with the Occupational Safety and Health Administration OSHA under Choose an item. Over Choose an item. days have passed since you filed your complaint with OSHA. Under the Act, if the Secretary has not issued a final decision within Choose an item. days of the filing of the complaint, and there is no showing that such delay is due to the bad faith of the complainant, the complainant may bring a de novo action in Federal District Court.

You provided this office with a copy of your federal court complaint on (DATE). As a result of your electing to proceed with your case in federal court, rather than before the Secretary of Labor, this office is dismissing your complaint.

Sincerely,

(RSI Name)

Regional Supervisory Investigator

Cc: Respondent/Respondent’s Attorney

ATTACHMENT 3 - Partner Agency Notification

PARTNER AGENCY ADDRESS
See O:\DWPP\Active Files\OWPP Info Docs\Distribution of Complaints and Findings

Re: [Respondent] / [Complainant] / Case No. [X-XXXX-XXX-XX]

Dear [Sir or Madam]:

The above referenced matter involves a complaint of discrimination under Choose an item.

Over Choose an item. days have passed since Complainant filed a Choose an item. complaint and Complainant exercised the option to file a civil action in federal district court. Therefore, the case before the Department of Labor is dismissed.

Sincerely,

[RSI Name]

Regional Supervisory Investigator

DWPP (via OSHA.DWPP@dol.gov)