Workplace Complaint

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REPORTER

Who is reporting? *

Reporter Mobile Phone *

Reporter Personal Email *

Are you a Local Union Steward? *

Yes

ISSUE/INCIDENT

What happened or is happening? *

Describe incidents which gave rise to othe grievance.

Name and Classification of involved employee(s). *

Is involved employee in probation period? *

Yes

When did this occur? *

Month

Day

Year

Employee Home Email *

Employee Mobile Phone *

LOCATION

Department and Unit of Incident *

Building/Space where incident occurred. *

Name and Title of Employees Supervisor *

Provide union contract article(s) subject to violation. *

Additional comments and recommended corrective action management should take. *