UPS Grievance Form

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

Please use the name UPS has on file
Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Employer*
Full-time or part-time*

Full-timePart-time
Occupation*
Full-time
Combo Shift*
Full-time
Worksite/Center Location*
Full-time
Worksite/Center Location*
Part-time
Occupation*
Part-time
LKEUT Regional Hub "New Building"
380 S 6400 WEST, SALT LAKE CITY, UT
Parkway, West Valley Hub "Old Building"
2040 Parkway Blvd. West Valley City, UT 84119
Employee I.D.#*
Manager/Supervisor*
Seniority Date*

MonthDayYear
Date
Type of Grievance*
Incident Date*
Example: "5/24/25" or "for week ending 5/25" or "from 5/12 - 5/24" (ONLY INCLUDE DATE)
Please include the date of the violation and how many hours worked with your unpaid lunch excluded.
Please file 9.5 grievances on the 9.5 Grievance Form at this link:

Click here: https://form.jotform.com/202334857359058
For Supervisor Working grievances you must include:

1) The date of the violation
2) Name of supervisor doing bargaining unit work
3) Times that the supervisor worked (Ex: 5:03-5:23am)
4) Details of the work the supervisor performed
5) Witnesses, if available
Did you tell the supervisor(s) to stop working? Yes or no? If yes, name the supervisor(s).*
For payroll or daily guarantee grievances you must include:

1) The date of the violation
2) Details of missing pay
3) When you notified management of the payroll shortage

Include "Requesting penalty pay" if you would like applicable penalties.
To protest your production ride, please include

1) The days of your production ride
2) Which supervisor rode with you
3) Details on how this production ride varied from your typical work day, including any assistance from management
You must address the issue with a Shop Steward before filing a grievance.
Did you speak to a Steward about the issue before filing? If yes, who was your Steward?*
You must notify the Safety Committee before filing a grievance.
Did you notify the Safety Committee of your safety concern?*
You must address the issue with a Shop Steward before filing a grievance.
Did you speak to a Steward about the issue before filing? If yes, who was your Steward?*
Give Details of complaint. **Be sure to include date violation occurred.***

0/100
When you protest discipline, it allows the Union to discuss the merits of the issued discipline with UPS. You will not serve your suspension dates or termination if you protest your discipline. All warning letters are automatically protested and do not require a grievance.

You must file a separate grievance for each suspension or termination letter.

Contact your Business Agent with additional information regarding your discipline.
Select to Protest Discipline*
Type of Discipline
*OPTIONAL* What date were you disciplined for?
*OPTIONAL* Provide details of the discipline and any information you would like your business agent to have. This information will not be sent to the company.
Requested Remedy:*

0/50
This will constitute Teamsters Local 222 or any employee or agent designated by them as my attorney-in-fact. Any grievance received after 4:30 pm will be considered received at 9:00 am the next business day.
Grievant's Signature *

Clear
When did you join Local 222?*

MonthDayYear
Date
DateTime
Please verify that you are human*
Should be Empty:

UPS Grievance Form

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