GRIEVANCE SUBMISSION FORM

Employee Information:
Name:	[YOUR NAME]
Position:	[POSITION]
Department:	[DEPARTMENT]
Grievance Information:
Date of Incident:	[DATE]
Location of Incident:	[LOCATION]
Details of Grievance:	[DETAILS]
Have any steps been taken to resolve the issue?	[YES/NO]
If yes, please provide details:	[DETAILS IF ANY]

Confidentiality

Your grievance will be handled with the utmost confidentiality. Please note that the organization will only disclose information on a need-to-know basis for investigation and resolution purposes.

Acknowledgment and Follow-Up

Upon receipt of your grievance, the organization will acknowledge it within 7 business days and provide an estimated timeline for resolution.

Declaration

I hereby declare that the information provided in this Grievance Submission Form is accurate and complete to the best of my knowledge.

Complainant's Name: [Your Name]

Signature: _______________________

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