Union Fact Sheet
You may also download a PDF file by clicking
this link
TC Local 1976 Union Fact Sheet
For The Union Only
To be filled out by the Steward / Local
Chairman attached to the UNION COPY of
Grievance No.________ Local______
Who is involved
Name______________________________________
Check No___________ Department_______________________________________
Job and
Class__________________________________ Rate____________
Seniority Plant Service (date)_____________________
Department Service Date___________
Job Service Date________________________
Foreman or Management Involved
Name______________________________________ Department________________________________ Title________________________________________
Witnesses or Other Persons Involved
Name____________________________________________
Department_______________________________________
Job and Class__________________________
Phone Number_________________
Name____________________________________________
Department_______________________________________
Job and Class__________________________
Phone Number_________________
Name____________________________________________
Department_______________________________________
Job and Class__________________________
Phone Number________________
What happened? What is the grievance about? Make sure to include all points mentioned on the checklist for reach type of grievance.
When did the grievance occur? (date and time grievance began. How often ? for how long? Is it within the time limits to proceed with a grievance?
Where did the grievance occur? (exact location-department, machine, aisle, job number, etc. Include diagram, sketch or photo.
Why is this a grievance? (Violation of contract? Supplement? Law? Past Practice? Safety Regulation? Rulings or Awards? Unjust treatment ? Local Rule? Etc
Want grievance settled and redress in full, adjustments necessary to completely correct situation: In case of discharge ask for back pay.
Company Contends
Company record of conduct. Warning and or penalties for lateness, attendance, quantity or quality of work.
Dates Reasons
Verbal Warnings issued________________ ____________________________
Written warnings issued________________ ____________________________
Penalties Imposed________________ ____________________________
Additional Information Information given by witnesses. Print the name of each witness followed by a summary of what each saw and get a signed statement if necessary.
Documentary Evidence : Seniority lists, wage schedules, work ticket, record of similar grievances, rule violated etc
Date:_____________ Signature of steward/chairman___________________________
TC Local 1976 Union Fact Sheet
