Ps Form 8191 - Usps-Nrlca Joint Step 1 Grievance Form

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USPS-NRLCA Joint Step 1 Grievance Form
1a. Grievant’s Name (Last, first, middle initial)
1b. Grievant’s EIN (Employee Id Number)
1c. Grievant’s Title, Designation Code, and Route No.
1d. Telephone No. (include area code)
1e. Grievant’s Mailing Address
2a. Post Office
2b. Branch/Station
2c. Telephone No. (include area code)
3a. Date of Incident
3b. Date of Step 1 Discussion with
3c. Was Grievance Timely? (Explain)
(Filing date)
4. Issue (Complaint)
5. Contract Provisions (Articles at issue)
6. Full, Detailed Statement of Undisputed Facts (Attachments, as necessary)
7. Management’s Full, Detailed Statement of Disputed Facts (Attachments, as necessary)
8. Management Contentions
9. Union’s Full, Detailed Statement of Disputed Facts (Attachments, as necessary)
10. Union Contentions
11. Remedy Sought by the Union
12a. Disposition (Check one)
12b. Date of Disposition
Settled
Denied
Withdrawn
Sustained
Other (Specify)
13. Signature of Installation Head of Designee and Telephone No.
14. Signature of Union Step 1 Official and Telephone No.
8191
PS Form
, March 2007

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