Formal Grievance example

We have an example of a Formal Grievance form in Tanzania - with space for employee comments, managers comments, grievance protocol, what to do if you have a work grievance

FORMAL GRIEVANCE FORM

(TO BE COMPLETED BY THE EMPLOYEE LODGING THE GRIEVANCE IN TERMS OF STAGE 2 OF THE GRIEVANCE PROCEDURE)

 

NAME OF EMPLOYEE:

SEX:

CAUSE OF THE GRIEVANCE:

 

SOLUTION REQUESTED:

 

SIGNATURE OF EMPLOYEE:
DATE:

SIGNATURE OF EMPLOYEE REPRESENTATIVE:

 

 

PART II

TO BE COMPLETED BY THE MANAGER WHO DEALT WITH THE GRIEVANCE IN THE INFORMAL AND STAGE ONE OF THE FORMAL PROCEDURE (UNLESS NOT APPLICABLE IN TERMS OF CLAUSE 2(2) OF THE GRIEVANCE PROCEDURE)

 

DATE RECEIVED:

NAME OF MANAGER:

STEPS TAKEN TO RESOLVE GRIEVANCE:

 

COMMENTS ABOUT THE GRIEVANCE:

 

REMEDY PROPOSED BY MANAGER DEALING WITH THE GRIEVANCE:

 

DATE:

*The fact that a manager refuses to sign the form does not prevent the employee from referring to the next state of the grievance procedure. The employee should note however that the manager refused to sign.

 

PART III

MANAGER

(TO BE COMPLETED BY MANAGER DEALING WITH THE GRIEVANCE IN TERMS OF STAGE TWO OF THE INFORMAL PROCEDURE)

 

DATE RECEIVED:

SENIOR MANAGER’S COMMENTS:

 

OUTCOME:

 

 

SIGNATURE OF SENIOR MANAGER:

DATE:

EMPLOYEE’S SIGNATURE:

DATE:

SIGNATURE OF EMPLOYEE REPRESENTATIVE:

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