Form 19 Consent of Aggrieved Employees to the ... - UNDE

[Pages:2]Public Se r v ice La b o u r Relations Bo a r d

Com m ission de s relations de travail dans la f on ct ion publique

P.S.L.R.B. File Number FOR OFFICE USE ONLY

Form 1 9 ( Subsection 77( 2) )

CON SEN T OF AGGRI EVED EM PLOYEES TO TH E PRESEN TATI ON OF A GROUP GRI EVAN CE

Public Service Labour Relat ions Act

1. Nam e of the bargaining agent:

2. Nam e of the em ployer:

3 . Description of the bargaining unit to w hich the aggrieved em ployees belong:

4 . Portion of the federal public adm inistration w here the aggrieved em ployees w ork:

5 . Term of the collective agreem ent or arbitral aw ard relating to the group g r ie v a n ce :

from

to

(dd/ mm/ yyyy)

(dd/ mm/ yyyy)

6 . Provision of the collective agreem ent or arbitral aw ard that is the subject of the group grievance:

7 . Statem ent of group grievance:

8 . Cor r e ct ive a ct ion sought :

We, the undersigned, hereby consent to the presentation of the group grievance under sect ion 215 of t he Public Service Labour Relat ions Act .

N AM E OF EACH AGGRI EVED EM PLOYEE

(print in block letters)

SI GNATURE

DATE ( dd/ mm/ yyyy)

W ORK LOCATI ON

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