In today's fast-paced work environment within the Department of Homeland Security (DHS), maintaining a clear and efficient process for addressing grievances is paramount for the welfare of unclassified employees. That's where the Policy #1502 Attachment #2, more commonly known as the DHS UNCLASSIFIED SERVICE GRIEVANCE FORM, comes into play. This document serves as a comprehensive tool for employees to formally present their non-disciplinary employment concerns, ensuring their voice is heard in a structured manner. Prior to leveraging this form, employees are guided to engage in a dialogue with their supervisors to resolve issues at the earliest opportunity. The form itself meticulously captures essential employee details, the supervisor involved, and the specific nature of the grievance, laying a foundation for a transparent review process. Moreover, it demands an accurate recounting of incident(s) backed by any supporting documentation, which underscores the importance of substantiating claims with factual evidence. Required to be submitted to the OHRMD – Employee Relations Section, this grievance procedure underscores a commitment to an equitable work environment by demanding accountability and encouraging open lines of communication.
| Question | Answer |
|---|---|
| Form Name | Form 1502 2 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | Supervisors, OHRMD, NW, UNCLASSIFIED |
Policy #1502
Attachment #2
DHS UNCLASSIFIED SERVICE GRIEVANCE FORM
Unclassified Employees are to refer to the Grievance Procedure for Unclassified
Employees (Policy #1502) before completing this form
Employee Name:_____________________________________ Employee ID#:___________________
Job Title:________________________ |
Division/Office/Facility:___________________________ |
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Scheduled Work Hours:___________________ |
Best time to reach you by phone:_____________ |
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Work Telephone #:_______________________ |
Home Telephone #:________________________ |
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Can you receive material by fax?_____________________ |
Fax #:________________________ |
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Employee’s Preferred Mailing Address:___________________________________________________
Street Name or P.O. Box
__________________________________________________________________________________
CityStateZip code [include nine (9) digits]
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Supervisor involved with issue(s): _______________________________________________________
Supervisor’s Telephone #:__________________________ |
Fax #:________________________ |
You are encouraged to discuss the
prior to filing a grievance.
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I am filing a grievance and have completed page two (2) of this form. The
____________________ |
___________________________________________________________ |
Date |
Employee’s Signature |
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Deliver mail or fax DHS UNCLASSIFIED SERVICE GRIEVANCE FORM and supporting documents to:
OHRMD – Employee Relations Section
28th Floor
Two Peachtree Street, NW
Atlanta, Georgia
FAX #:
For information or assistance regarding the grievance process, please call
Received by OHRMD: |
|
Grievance #: |
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Form |
Page 1 of 2 |
Revised: July 1, 2009 |
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DHS UNCLASSIFIED SERVICE GRIEVANCE FORM (CONTINUED)
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This section must be completed. |
DATE ISSUE(S) OCCURRED |
LIST ISSUE(S) |
[Within Ten (10) Work Days |
[Example: Unsafe or Unhealthful Working Conditions] |
of Filing Grievance] |
|
__________________________ |
_______________________________________________ |
__________________________ |
_______________________________________________ |
__________________________ |
_______________________________________________ |
__________________________ |
_______________________________________________ |
__________________________ |
_______________________________________________ |
Additional documents may be submitted for further explanation.
Number of supporting documents attached ___________
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Describe what happened, when and where, and indicate names of others involved in the grievance.
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Are you alleging erroneous, arbitrary or capricious interpretation or application of human resource/
personnel policies or procedures?Yes______No_______
If yes, please specify which ones and how:_________________________________________________
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Requested Relief:_____________________________________________________________________
Employee must send copies of the grievance and supporting documents to the following persons:
_______________________________________________________
Supervisor Involved
_______________________________________________________
Appropriate Human Resource/Personnel Representative
_______________________________________________________
Division/Office Director or Facility Administrator/Superintendent
Form |
Page 2 of 2 |
Revised: July 1, 2009 |