8555 16th St Suite 550

           Silver Spring, MD. 20910-3320

                      301-608-8080

OFFICE AND PROFESSIONAL EMPLOYEES

               INTERNATIONAL UNION

                                                                                LOCAL 2, AFL-CIO

                                                                       GRIEVANCE REPORT FORM

GRIEVANT ___________________________________ DATE ____________

EMPLOYER ________________________________________

DEPARTMENT __________________________

CLASSIFICATION ____________________________________

NATURE OF GRIEVANCE ____________________________________________

_____________________________________________________________________

_____________________________________________________________________

_____________________________________________________________________

ARTICLE (S) VIOLATED REMEDY SOUGHT ___________________________________

REMEDY SOUGHT __________________________________________________________

____________________________________________________________________________                                                                        

                                                                                    ____________________________

                                                                                           (Grievant’s Signature)

FIRST DECISION _____________________________________________________________

_____________________________________________________________________________

_____________________                                                                  _______________________

(Employer Representative)                                                                     (Union Representative)

SECOND STEP DECISION __________________________________________________________

______________________________________________________________________________

____________________                                                                    ________________________

(Employer Representative)                                                         (Union Representative)

THIRD STEP DECISION _______________________________________________________________

_____________________                                                                  ________________________

(Employer Representative)                                                                     (Union Representative)

ARBITRATOR’S AWARD _____________________________________________________________

Note: Union Signature at each step is only indicative that such step is taken and does not reflect concurrence in the decision rendered unless so specified in his/her stated position.