Document Date
Meeting Description
Document Type
Meeting Date
Page Number
115
AFSCME Council 93
OFFICIAL GRIEVANCE FORM
Employer Date Submitted: Step 1
Local No. Dept. :
Local Grievance No. Class Action rn re
Grievant 4.
Title Sy
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. | TO MANAGEMENT. 1 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 date/s who, when, where, what, why.)
Witnesses:
REMEDY:
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