TEAMSTERS LOCAL 767 GRIEVANCE FORM
Fill out this form, print and give a copy of your grievance to your Union Steward to complete the first step in the grievance process. For assistance filling out your grievance, reach out to your Union Steward.
First and Last Name
*
Last 4 digits of Social Security Number
*
Today's Date
*
/
Month
/
Day
Year
Date
Phone
*
Seniority Date
*
When did you start at your company?
Best time to call you
*
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Classification
*
Please Select
Air Driver
BaSE Mechanic
Carwash
Clerk
Combo/22.3
Feeders
Fueler
GSE Mechanic
HUB
Irreg Cart
Auto-Mechanic
RPCD
Ramp
Revenue Recovery
Shifter
Tender
22.4
Americold
Safran Seats
Business Agent
Shift
*
Please Select
Sunrise/PreLoad
Day
Twilight
Night
On Call
Other
Employer/ Location
*
Please Select
UPS-Chalk Hill
UPS-Dallas
UPS-Denton
UPS-DFW
UPS-Fort Worth
UPS-Granbury
UPS-Haslet
UPS-Independence
UPS-Longview
UPS-Lonestar
UPS-McKinney
UPS-Mesquite
UPS-Palestine
UPS-Sherman
UPS-Sulphur Springs
UPS-Tyler
UPS-Vernon
UPS-Waco
UPS-Wichita Falls
AMERICOLD-Meacham
AMERICOLD-Railhead
SAFRAN- Gainesville
Teamsters Local 767
Your Email Address
*
example@example.com
Current pay rate
*
Nature of Grievance
*
Unjust Discharge
Unjust Suspension
Protest of Warning
Pay Claim
Other- type below or skip to next question for Pre-filled Grievances
Pre-filled options for Nature of Grievance
Please Select
9.5 Rights Violation
Subcontracting
Supervisor Working
What type of Unjust Discharge?
Actual Discharge- you are actively being fired
Intent to Discharge- you are not yet fired but you may have received an intent to discharge letter
WHEN did the violation occur? Give date(s) and time(s)
*
WHERE did the violation take place?
*
WHO were the people involved? Give the first and last names of all witnesses along with their phone numbers, if known. Identify all management personnel involved and indicate their title or area of responsibility.
*
WHAT happened? Give a BRIEF description of the facts of your claim. Do not argue your case here. Just the facts
WHAT happened? Give a BRIEF description of the facts of your claim. Do not argue your case here; Just the facts please.
*
The company will see this- please keep it brief.
0/1190
WHAT happened? Give a Brief description of the facts of your claim. Do not argue your case here. Just the facts.
WHAT happened? Give a Brief description of the facts of your claim. Do not argue your case here. Just the facts.
WHAT happened? Give a BRIEF description of the facts of your claim. Do not argue your case here; Just the facts please.
Contract Articles Violated? Choose "other" option to type your own articles.
Copy of contract articles violated
Contract Articles Violated? Type other Articles here.
Contract Articles Violated?- Supervisor Working
Contract Articles Violated?- Subcontracting
Contract Articles Violated?- 9.5 Rights Violation
SETTLEMENT REQUESTED BY GRIEVANT: To be "made whole" in every way in addition to the following remedy
*
0/725
SETTLEMENT REQUESTED BY GRIEVANT: To be "made whole" in every way in addition to the following remedy- Subcontracting
0/725
SETTLEMENT REQUESTED BY GRIEVANT: To be "made whole" in every way in addition to the following remedy- Supervisor working
0/725
SETTLEMENT REQUESTED BY GRIEVANT: To be "made whole" in every way in addition to the following remedy- 9.5
0/725
THIS EMPLOYEE STATEMENT IS PRIVILEGED INFORMATION FOR UNION USE ONLY.INSTRUCTIONS TO EMPLOYEE: Do not give a copy of this statement to management! Detach this page and give this statement to your Union Steward! The purpose of this statement is for you to tell why you think you have a case. Tell why you feel management has committed a violation.
This statement will appear on page 3
0/3700
GRIEVANT'S SIGNATURE
*
By the above signature I hereby give authority to any representative of the Union to represent me in this matter in the event I am not present at any subsequent hearing on this grievance.
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