UPS Grievance Form

UPS Grievance Form
PLEASE FILL OUT COMPLETELY
Name *

First Name Last Name
Phone Number *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email *
example@example.com
Name of company against whom you are filing complaint: *
Occupation *
Seniority Date *

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

0/100
When did you join Local 222?

Month Day 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
Should be Empty:

PLEASE FILL OUT COMPLETELY