GrievanceForm .pdf

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Original filename: GrievanceForm.pdf
Title: Absence request form
Author: Eric

This PDF 1.6 document has been generated by Acrobat PDFMaker 15 for Word / Adobe PDF Library 15.0, and has been sent on pdf-archive.com on 15/11/2015 at 23:38, from IP address 69.23.x.x. The current document download page has been viewed 392 times.
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Local 1426

Email

Grievance Form
Grievance Information
Employee Name:
Shift: X1

Phone Number:
Department: Maintenance

Date(s) of Occurance:
Grievance Fact Sheet

Nature of Grievance:

including but not limited to the above.

Resolution:

and to make whole, including but not limited to the above.

I authorize Local 1426 as my representative to act for me in the disposition of this grievance.
Signature(s):

Date:

First Step
Date Submitted:

Date of 1st Step:

Date of Answer:

Resolved:

If Resolution is different:
Steward’s Signature:

Supervisor’s Signature:

Second Step
Date Submitted:

Date of 2nd Step:

Date of Answer:

Resolved:

If Resolution is different:
Steward’s Signature:

Supervisor’s Signature:

Third Step
Date Signed In:

Date of 3rd Step:

Date of Answer:

Grievance #

If Resolution is different:
Chief Steward’s Signature:

On this date,

Plant Manager/HR Signature:

, this grievance was voted to go to Arbitration

Chief Steward’s Signature:
Business Agent given copies of all documents

not to go to Arbitration.

President’s Signature:
B.A. Signature:

Date:


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