HTML version of the form: Grievance Transmittal Form

Protected when completed

Department use only

Reference No.:

Please note:
In accordance with PSLRA s. 207, all departments and agencies within the core public administration have an informal conflict management system (ICMS) in place. Its existencedoes not affect an employee’s right to file a grievance. However, managers, employees and bargaining agent representatives are encouraged to use the ICMS when appropriate, atany stage of the grievance process, in an attempt to informally address workplace differences.

Section 1

Section 2

To be completed by employee (not applicable for group grievances)

Section 3

To be completed by bargaining agent representative where applicable

Approval for presentation of grievance relating to a collective agreement or an arbitral award, and agreement to represent employee are hereby given

Section 4

To be completed by immediate supervisor or local officer in charge

TBS/SCT 340-54 (2006/02)

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