American Postal Workers Union, AFL-CIO

1

GRIEVANT/PERSON OR UNION (Last Name First)

2 EIN

3

JOB NO../PAY LOCATION (UNIT/SEC/CR/STA/OFC)

4 DISCIPLINE

5

UNIT/SEC/BR/STA/OFC

6

STEP 1 DECISION BY (NAME AND TITLE)

American Postal Workers Union, AFL-CIO

ADDRESS

CITY

STATE

STEP 1 GRIEVANCE OUTLINE WORKSHEET

HQ Revised 04/24/12

ZIP

PHONE NO.

CRAFT

STATUS

LEVEL

STEP

DUTY HOURS

OFF DAYS

E-MAIL

POSTAL INSTALLATION LEVEL

CONTRACT

WORK LOCATION CITY AND ZIP CODE DATE

SENIORITY

PREF. ELIGIBLE YES NO

LOCAL GRIEVANCE NO.

INCIDENT DATE/TIME

USPS REP - SUPR

GRIEVANT AND/ OR STEWARD

DATE/TIME

INITIALS

(ONLY VERIF IES

DATE OF DECISION)

Background:

Corrective action: Management response:

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