Fillable State Employee Grievance Form printable pdf download

State Employee Grievance Form

Download a blank fillable State Employee Grievance Form in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete State Employee Grievance Form with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

Print Form

Employee Grievance

_________________________________________________________ ___________________________________

Grievant’s Name

Date

_________________________________________________________ ___________________________________

Delegate’s Name

Phone #

Facility / Department / Unit

STEP 1

Written presentation made to _________________________________ ______________

Appointing Authority

Date

STEP 1

NATURE OF GRIEVANCE:

(Include contract violation. Attach additional information to this sheet if necessary.)

__________________________________________________________________________

REMEDY DESIRED:

__________________________________________________________________________

____________________________________________

Grievant Signature

Delegate or Union Rep. Signature

Received by: _________________________________

_______________

Signature

Date

STEP 1 (Appointing Authority)

DISPOSITION:

Copy to:

Answer received

_______________

Delegate

Settled

STEP 2 (Office of Secretary)

Management

Grievance notification sent

_______________

Withdrawn

Grievant

Grievance meeting held on

_______________

Answer received on

_______________

Union

Appealed to Arbitration

STEP 3 (Director of the OFM Labor Relations Office)

Grievance notification sent

_______________

Date: _______________

Pre-arbitration meeting held on

_______________

Appeal to arbitration (FMCS)

_______________

SEIU 1199NW 15 S. Grady Way Ste. 200 Renton, WA 98055 1-800-422-8934 Fax 425-917-9707

C:\Documents and Settings\Patti Mallin\My Documents\seiu\1199nw\newsite\resources\Employee Grievance Form - State_072706_192321.doc

State Employee Grievance Form

Related Articles

Related forms

Related Categories