1199 Grievance Form PDF Details

When workplace disputes arise, the 1199 Grievance Form is the critical tool for CSU/SEIU District 1199 employees seeking to formally address and resolve issues. This document outlines a structured multi-step process designed to give employees a fair and organized path to resolution.

The grievance procedure begins with an informal resolution attempt. The employee first meets with their immediate supervisor to discuss the issue directly. If no resolution is reached within the specified timeframe, the matter proceeds to Step 2, where a written grievance is filed with the Human Resources Department. At each stage, employees may be accompanied by a union representative from SEIU District 1199.

If the written grievance remains unresolved, it can be appealed to higher HRD levels and ultimately submitted to arbitration or mediation. Employees must provide detailed information: their employment details, the specific nature of the grievance (contract violation, university policy, or law), and the remedy they are seeking. Strict deadlines apply at every step, so tracking each filing date carefully is essential.

The form also highlights the collaborative nature of the grievance procedure. Union representatives can advocate on behalf of the employee throughout the process, helping navigate procedural requirements and ensuring the employee's rights are protected. This collaborative approach provides expert guidance during what can be a complex and stressful process.

QuestionAnswer
Form Name1199 Grievance Form
Form Length1 pages
Fillable?Yes
Fillable fields1
Avg. time to fill out27 sec
Other namesseiu district 1199 form online, seiu 1199 grievance, csu seiu 1199, seiu district grievance form

Form Preview Example

CSU/ SEIU DISTRICT 1199

GRIEVANCE FORM

Submit original to management and make four (4) copies and distribute to: (1) Grievant, (2) Chief Steward, (3) Union Staff Representative, and (4) Steward.

EMPLOYEE _________________________________

DATE _______________________________

JOB CLASSIFICATION

 

_

__

 

DEPT. ________

___________________

SUPERVISOR _________________

 

 

 

DATE OF HIRE ________________________

 

 

 

 

 

 

 

 

Summarize nature of grievance. Please specify the basis of the grievance, including all contract violations, University policies, past practices and/or laws, etc. Include all relevant dates.

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

(Use additional sheets of paper if necessary.)

DESIRED REMEDY:

________________________________________________________________________________________

________________________________________________________________________________________

______________________________ and that he be made whole in any and all other respects.

Step 1: Informal Resolution (Discussion with Supervisor) (within 10 working days of the event on which the grievance is based)

Discussion Date: _________Supervisor's Response:

________________________________________________________________________________________

________________________________________________________________________________________

Step 2: Written Grievance Form to HRD Representative and Department Head or Appropriate Administrator (within 10 working days of the event on which the grievance is based)

Date Filed: ____________________ Meeting Date: ________________

(within 5 working days after filing written grievance) Relevant Information:

_____________________________________________________________________________________

_____________________________________________________________________________________

Date Response Received: (within 7 working days of meeting)__________________

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Response:

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

Step 3: Written Appeal to Vice President for HRD (within 5 working days after receipt of Step 2

response or within 12 working days after Step 2 meeting if no response is received)

Date Filed: _______________ Meeting Date__________ (within 7 working days after of receipt of appeal)

Relevant Information:

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________

Date Response Received: (within 7 working days of meeting) _____________________

Response:_______________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

_______________________________________________________________________________

Step 4: Written Appeal to Arbitration (Separate form to be filled out for Request for Arbitration. Notice to Vice President for HRD within 10 working days after the next regularly scheduled Union Executive Board Meeting, but no later than 45 calendar days after receipt of the Step 3 response.)

Date Filed: _____________________________Arbitration Date: ______________

Date Response received from Arbitrator: _________________________________

Resolution:

________________________________________________________________________________________

____________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________

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Mediation (Optional) (All parties may mutually agree to pursue mediation within the 45 calendar day period prior to Arbitration notification in Step 4; the use of mediation must be confirmed in writing; Step 4 notification of intent to arbitrate extended until 21 calendar days after conclusion of mediation, if used.)

Date Requested: ________________________________ Mediation Date: ____________________________

Relevant Information/Resolution ______________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

Unless otherwise indicated, by signing this grievance form, the aggrieved employee grants authorization to the Union to act in his/her behalf and to advance the grievance through the steps of the grievance procedure.

_____________________________________

____________________

Signature of Aggrieved Employee

Date

_____________________________________

____________________

Signature of Union Representative

Date

______________ I do not wish the Union to advance my grievance without express authorization.

3

How to Edit 1199 Grievance Form Online for Free

The guide below explains how to complete the 1199 Grievance Form, who should use it, and answers to common questions about the filing process. For other employment-related documents, see the 1199 SEIU form and the employee status change form.

How to Fill Out the 1199 Grievance Form Step by Step

Step 1: Identify the Basis of Your Grievance

Before filing, identify which contract article, university policy, or law has been violated. The form requires you to specify the exact basis for your complaint. Common bases include violations of the collective bargaining agreement, university HR policies, or applicable state and federal laws.

Step 2: Complete the Employee Information Section

Fill in your full name, job title, department, and employee ID number. Include your supervisor's name and the date the violation occurred. Accurate employee information is required for the grievance to be processed without delay.

Step 3: Describe the Grievance in Detail

In the grievance description field, explain what happened in clear, factual terms. Include dates, names of those involved, and any witnesses. Describe the specific policy or contract provision that was violated and how the violation affected you.

Step 4: State the Remedy Sought

Specify what resolution you are requesting. This may include reinstatement, back pay, correction of a personnel record, or another specific remedy. Be clear and specific in your request so the Human Resources Department can evaluate it properly.

Step 5: Submit Before the Filing Deadline

The 1199 Grievance Form has strict deadlines at each step. The initial informal resolution attempt must begin within the timeframe set in your collective bargaining agreement after the incident. Missing a deadline can end the grievance process, so submit your form promptly after the violation occurs.

Who Needs the 1199 Grievance Form?

This form is for employees covered under the CSU/SEIU District 1199 collective bargaining agreement. If you work at a California State University campus under this agreement and believe a contract provision, university policy, or law has been violated, you are eligible to file a grievance. A union representative can assist you throughout the process. You may also find the complaint form or the labor law checklist useful for related filings.

Frequently Asked Questions About the 1199 Grievance Form

What deadlines apply when filing a 1199 grievance?

Deadlines vary by step and are set in the collective bargaining agreement. The informal resolution attempt typically must begin within 30 days of the violation. Written grievances and subsequent appeals each carry their own timeframes. Review the agreement or consult your union representative for exact dates.

Can I file a grievance without a union representative?

Yes, but having a union representative is strongly recommended. The representative can help you identify the correct contract provisions, prepare your documentation, and advocate at each stage of the grievance process.

What happens if the grievance is not resolved at Step 2?

If the Human Resources Department does not resolve the grievance at Step 2, you may escalate to Step 3, which involves a higher HRD level review. If the matter remains unresolved after all internal steps, it may proceed to arbitration or mediation under the collective bargaining agreement.

Is the 1199 Grievance Form the same as a general complaint form?

No. The 1199 Grievance Form is specific to CSU/SEIU District 1199 members and addresses collective bargaining agreement violations. A general workplace complaint is handled through a different process. Contact your HR department or union representative to determine the correct form for your situation.