Grievance Fact Sheet copy – CANADIAN UNION OF POSTAL WORKERS

Date *
Last Name *
Given Name *
Employee ID number *
Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Phone *
Email *
Employee: *
Check OneFull TimePart TimeTemporaryProbation
First Date of Service *
Employer *
Work Location *
Classification *
Group 1 (PO4 / PO5)Group 2 (Letter Carriers / M.S.C.)R.S.M.C.Group 3Group 4
Shift
Section / Route
Name of Shop Steward *
Date of Investigation:

Text area can hold approximately 1000 words *
On what date did you become aware, for the first time, that you had a grievance? *
Corrective Action Requested *
Please attach any documentation you have to support your facts. Examples are 24 notice of interview, copy of staffing sheet, pay stubs.
If you are unsure of what other documents needed or how to obtain, seek out a shop steward.
Scan documents or take a clear photo.
Copy of 24 Hour notice of interview upload
Copy of shop steward notes upload If you have more than 2 (two) documents, please forward to tspurgeon@cupw560.ca
Narrative of interview upload
Letter of decision and/or suspension upload
Witness Statement upload
Additional upload
Any other documents you may email to Frank Thoms at fthoms@cupw560.ca
By Entering your name in the Signature field and clicking Submit, you confirm and agree that all information is accurate and correct. *