9.5 GRIEVANCE RECORD

9.5 GRIEVANCE RECORD

In the 2023-2028 contract you now have 20 DAYS to FILE a grievance from the INCIDENT DATE
Name*

First NameLast Name
Phone Number*
Address*

Street Address

CityState / Province

Postal / Zip Code
Email*
example@example.com
Name of company*
Occupation*
Seniority Date*

MonthDayYear
Date
Employee I.D. # (If applicable)*
Worksite Location / Center Name*
Manager/Supervisor*
Violation of National Master UPS Agreement Article 37, section 1(c) for excessive overtime.

Please enter hours worked below, and if using a UPS timecard app, subtract any unpaid break time or lunch.

For weekending date: select the last Saturday of the week which your 9.5 violation occured.
This grievance is for weekending:*

MonthDayYear
Date
Hours for Monday
Use decimal format. Example: "9.52"
Hours for Tuesday*
Use decimal format. Example: "9.52"
Hours for Wednesday*
Use decimal format. Example: "9.52"
Hours for Thursday*
Use decimal format. Example: "9.52"
Hours for Friday*
Use decimal format. Example: "9.52"
Hours for Saturday
Use decimal format. Example: "9.52"
Total estimated hours over 9.5:
When did you join Local 222?

MonthDayYear
Date
This submission is written request that the grievant be paid the triple time penalty for these hours of excessive overtime.

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*
Monday Calculation
Tuesday Calculation
Wednesday Calculation
Thursday Calculation
Friday Calculation
Saturday Calculation
Should be Empty: