SENIORITY DATE NCS DATE
WORK TELEPHONE NO. HOME TELEPHONE NO.
SUPERVISORíS NAME PHONE NO.
††††††††††††††† GIVE COMPLETE STATEMENT OF FACTS CONCERNING THE GRIEVANCE CONDITION THAT EXISTS
The following is a statement of what happened to me on which action was in violation of Article
Of the Working Agreement.
SIGNED GRIEVANT DATE
I hereby give consent to the inspection by any authorized Union Representative of any records kept by the Company whichAffect the conditions of my employment, which may include Security Reports, Medical Records or Opinions. Police Court Records or Reports, or any other information which may be relevant and necessary to allow the Union to protect my rights under the Working Agreement between the Union and the Company. This authorization is given in accordance with the existing agreement between the Union and the Company.