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SEE ARTICLE BELOW AND DOWNLOAD THE ATTACHMENT.
Grievance Forms
Download:
Here is a downloadable copy of the statement of occurrence. Download and fill out and return to your Steward or V.P.
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CWA LOCAL 6016
NAME_____________________ ADDRESS____________________
WORK LOCATION________________HOME TELEPHONE________
SENIORITY DATE_________________WORK TELEPHONE_______
DEPARTMENT/FLOOR/UNIT_______________TITLE____________
SUPERVISOR’S NAME_______________________________________
The following is a statement of what happened to me on _______20___ :
Page 2
Statement of Occurrence
I HEREBY GIVE CONSENT TO THE INSPECTION BY ANY AUTHORIZED UNION REPRESENTATIVE OF ANY RECORDS KEPT BY THE EMPLOYER WHICH MAY AFFECT THE CONDITION OF MY EMPLOYMENT. THIS AUTHORIZATION IS GIVEN IN ACCORDANCE WITH THE EXISTING AGREEMENT BETWEEN THE UNION AND THE EMPLOYER.
SIGNED___________________________
RELEASE OF PERSONNEL AND/OR MEDICAL RECORDS
I, _________________________, THE UNDERSIGNED, DO HEREBY GRANT PERMISSION FOR ALL UNION REPRESENTATIVES INVOLVED TO EXAMINE, REVIEW AND OBTAIN COPIES, WHEN NECESSARY, OF ANY AND ALL PORTIONS OF MY PERSONNEL AND/OR MEDICAL RECORDS MAINTAINED BY THE COMPANY, WHICH ARE NECESSARY TO PROCESS A GRIEVANCE IN MY BEHALF.
I UNDERSTAND ALL INFORMATION AND DISCUSSIONS OF A PERSONAL NATURE PERTAINING TO THESE RECORDS OR COPIES OF IT WILL BE HELD IN STRICT CONFIDENCE UNLESS OTHERWISE STATED BY ME.
SIGNED_______________________________ DATE__________
GRIEVANT
SIGNED_______________________________ DATE_________
UNION REPRESENTATIVE
OPEIU #381, AFL-CIO
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