Board Of Aldermen - Agenda - 1/12/2021 - P80

AIFSCME Council 93

OFFICIAL GRIEVANCE FORM

Employer _ 7 Date Submitted: Step 1
Local No. Dept. 25
Local Grievance No. 4 Class Action 3,
Grievant 4.
Title 5:
Address Work Phone

Home Phone
Immediate Supervisor Title
I Authorize AFSCME Local___ As My Representative To Act For Me In The Processing Of This Grievance.

Date Signature of Employee _ —

Signature of Union Rep. Title

AT EACH STEP, MAKE 3 COPIES OF THE GRIEVANCE
1 TO THE UNION. 1 TOMANAGEMENT. | WORKING COPY

STATEMENT OF GRIEVANCE

ARTICLES AND SECTIONS of the contract which have been violated:

and any related articles, agreements, practices, rules, regulations, and law.

GRIEVANCE: State the facts (include dates who, when, where, what, why.)

Witnesses:

REMEDY: