UPS Grievance Form

UPS Grievance Form
PLEASE FILL OUT COMPLETELY
Name*

First Name Last Name
Phone Number*
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email*
example@example.com
Employer*
Occupation*
Seniority Date*

MonthDay Year
Date
Employee I.D.# (If applicable)*
Worksite/Center Location*
Manager/Supervisor*
Give Details of complaint. **Be sure to include date violation occurred.***

0/100
When did you join Local 222?

MonthDay Year
Date
This will constitute Teamsters Local 222 or any employee or agent designated by them as my attorney-in-fact empowered to receive on my behalf any monies due me.
Grievant's Signature *

Clear
Please verify that you are human*
Should be Empty:

PLEASE FILL OUT COMPLETELY