Cs Form 6a - Employee Grievance Form - Hillsborough County Civil Service printable pdf download

Grievance Procedures & Instructions

CS Form 6A

Policy & Informal Discussion:

It is the intent and desire of the Hillsborough County Civil Service Board to encourage discussion of any

employee grievance on an informal basis between the supervisor and an employee. Such discussion should be

held with a view to reach an understanding which will resolve the matter without the need for recourse to the

written grievance procedures.

However, any member of the classified service shall have the right at any time to secure consideration of any

grievance without fear of reprisal, retaliation, or discrimination. Matters of concern to employees should be treated

seriously, promptly, and with as much confidentiality as possible by those person in a position to provide redress.

Form:

Forwarded to:

CS Form 6A…………………….Immediate Supervisor

CS Form 6B…………………….Second-line Supervisor

CS Form 6C…………………….Next-in-line Supervisor

(form for contacting each additional

supervisor up to the agency head)

CS Form 6D…………………….Civil Service Office

Filing a Grievance with your Immediate Supervisor

CS Form 6A

Step #1: In order to file a grievance, you must complete and present CS Form 6A to your immediate supervisor within 5

working days, or 1 calendar week after the rule violation.

Section 1:

Please complete this section with your immediate supervisor’s name, the current date, as well as

the date of the incident in the appropriate areas.

Section 2:

Please state ALL of the Civil Service Law or Rule(s) and/or Appointing Authority Policy(s) that

have been violated.

•

Please describe very specifically ALL of the details & situation of your grievance. It is important that

you be specific in the full nature of the situation and details because those issues, and ONLY those

issues documented on CS Form 6A will be addressed in future correspondence. If you have any

additional issues that surface later within the grievance process, you may ONLY address those

additional issues as SEPARATE grievances through additional CS Forms 6A. If you need additional

space to describe your grievance, use a separate piece of paper and attach it to the form.

•

Please indicate what you feel would be an appropriate solution or action to be taken to resolve your

grievance.

•

Please indicate the number of attachments to your CS Form 6A, as well as printing & signing your

signature in the appropriate area.

It may be in your best interest to make copies of all sent & received forms throughout the grievance process for your

own records & documentation!

Step #2: Present your grievance (CS Form 6A) to your immediate supervisor who then has 5 working days to review (7

calendar days), respond, and return the completed form to you.

Step #3: If you are not satisfied with the solution that your immediate supervisor provides, then you may direct ONLY the

grievance stated on the original CS Form 6A to the second level of the process. Any additional grievances or issues that

should arise MUST be addressed on a SEPARATE form.

Section 3:

If you agree with your immediate supervisor’s solution, please complete this section with your

immediate supervisor’s name, the current date, an “X” marked if you agree with the presented solution, your

signature, and then return a copy of the CS Form 6A to your immediate supervisor for documentation.

If your immediate supervisor does not respond within 5 working days (7 calendar days) of receipt of your CS Form

6A or you do NOT agree with his/her presented solution, you may then proceed to using CS Form 6B.

CS Grievance Procedures & Instructions – CS Form 6A

(5/05)

Cs Form 6a - Employee Grievance Form - Hillsborough County Civil Service

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