Online Grievance Investigation Form

Complete ALL fields marked with an * below (you will get an Error if you don't) and be sure to provide adequate and relevant details. On submitting this form, it will be sent to the Grievance Officer, who will communicate with the Shop Steward and witness(es), if applicable, to continue with the PART "C" information included on page 2 of the paper version.

By Entering your name in the Signature field at the bottom of the form, you confirm and agree that all information is accurate and correct. Please refer to the Terms of Service for the CUPW Local 824 website before submitting any sensitive, personal information.

CONFIDENTIAL

PART "A" To be completed by the Grievor

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

HRID #

CPC Employee ID #

First Date of Service

Continuous Service Date

YYYY

Classification

Group 1 (P04 or P05), 2 (LC or MSC), 3, 4, RSMC, or T-Force

Shift

Section # or Wave #

Employee Type

Section/Route

Work Location/Post Office

Post Office Phone #

(###)

###

####

Time of Shift Start

Hour

Minute

Second

Time of Shift Stop

Hour

Minute

Second

Local

PART "B"

To be completed by the Grievor or the witness(es) with the help of the Shop Steward.

Name of Shop Steward

First Name

Last Name

Date of Investigation

YYYY

Date of Incident

The incident giving rise to the grievance occurred on:

YYYY

Time of Incident

Hour

Minute

Second

Location of Incident

Persons Involved

Supervisors and Witnesses

Supervisor Name

First Name

Last Name

Supervisor Name 2

First Name

Last Name

Witness 1

First Name

Last Name

Witness 2

First Name

Last Name

Grievance Information:

Who is involved? What is the problem? When did it occur? Where did it happen? Why is this a grievance?

In your own words, state all the facts:

Description of the Incident

Corrective Action Requested

Date

On what date did you become aware, for the first time, that you had a grievance?

YYYY

Signature

By Entering your name in the Signature field and clicking Submit, you confirm and agree that all information is accurate and correct. I hereby authorize the representative(s) of the CUPW to examine my personal file.

Supporting Documents

Please email 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 are needed or how to obtain them, seek out a shop steward.

Supporting Documents