Grievance Form Slip HR
GRIEVANCE FORM SLIP HR
Employee Information
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Full Name: [Employee's Full Name] |
Position: [Employee's Position] |
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Employee ID: [Employee ID] |
Date of Submission: [Date] |
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Department: [Employee's Department] |
Received by: [Receiver’s Name] |
Grievance Details
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Nature of Grievance: (Check the applicable box) |
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Harassment Discrimination Retaliation Workload Compensation Benefits Work Conditions Conflict with Colleague Other (Please Specify): ________________ |
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Description of Grievance |
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[Include a detailed description of the grievance, including the names of individuals involved, dates, times, locations, and any supporting evidence or documents.]
[Description]: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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Resolution Sought |
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[Describe the specific resolution or action you are seeking to address this grievance.]
[Resolution Sought]:
________________________________________________________________________________________________________________________________________________________________________________________________
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Witness Information
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Full Name: [Witness's Full Name] |
Department: [Witness’s Department] |
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Employee ID: [Witness's Employee ID] |
Date of Submission: [Date] |
Attachments (if any)
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[Attachments Included] |
Acknowledgment
I hereby acknowledge that the information provided in this Grievance Form Slip is true and accurate to the best of my knowledge. I understand that this grievance will be handled confidentially and in accordance with company policies and procedures.
Employee's Signature: [Signature]
Date: [Date Signed]
For HR Use Only
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Date Received: [Date] |
Received by: [HR Representative Name] |
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Action Taken:
Investigation Initiated Referred to Appropriate Department Other: ___________________ |
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HR Representative's Comments:
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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