2023 - 2026 SCLEA Memorandum of Understanding: Appendix C: MOU Grievance Form
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- Sample MOU Grievance Form
- Printable SCLEA MOU Grievance Form
Sample MOU Grievance Form
SCLEA MEMORANDUM OF UNDERSTANDING GRIEVANCE FORM
| For use only to process a grievance under the Grievance Procedure established in Article 30 of the Sonoma County Law Enforcement Association Memorandum of Understanding for employees in the Law Enforcement and Corrections/Probation Supervisory and Non-supervisory bargaining units. | |
| NAME | JOB CLASSIFICATION |
| DEPARTMENT/DIVISION | |
| ASSOCIATION | |
| STEP I | |
|
AN INFORMAL DISCUSSION WITH YOUR IMMEDIATE SUPERVISOR Before completing the remainder of this form, an informal discussion with your immediate supervisor must take place within ten (10) days from the date of the action causing the grievance. (Section 30.6) |
|
| SUPERVISOR’S NAME | TITLE |
| DATE DISCUSSION HELD | DATE OF SUPERVISOR’S RESPONSE |
| STEP II | |
| IF THE GRIEVANCE WAS NOT RESOLVED AT STEP I, STATE IT IN WRITING AT THIS STEP AND SUBMIT THIS FORM TO YOUR IMMEDIATE SUPERVISOR WITH A COPY TO THE COUNTY’S EMPLOYEE RELATIONS MANAGER WITHIN FIVE (5) DAYS AFTER RECEIPT OF THE IMMEDIATE SUPERVISOR’S RESPONSE FROM STEP I. (Section 30.7) | |
| DESCRIBE GRIEVANCE (If more space is needed, use additional paper.) | |
| DATE(S) OF INCIDENT(S) | |
| M.O.U. ARTICLE VIOLATED | |
| REQUESTED SOLUTION | |
| EMPLOYEE’S SIGNATURE | DATE |
| SUPERVISOR’S DECISION | |
| SIGNATURE | DATE |
| STEP III | ||
|
IF THE GRIEVANCE WAS NOT RESOLVED AT STEP II, THE ASSOCIATION MAY APPEAL THE DECISION TO THE NEXT HIGHER LEVEL OF SUPERVISION (IDENTIFIED BY THE DEPARTMENT HEAD) AND TO THE DEPARTMENT HEAD, WITH A COPY TO THE EMPLOYEE RELATIONS MANAGER WITHIN SEVEN (7) DAYS AFTER RECEIPT OF THE WRITTEN RESPONSE AT STEP II. (30.9) |
||
| DATE OF APPEAL | EMPLOYEE’S SIGNATURE | |
| DEPARTMENT HEAD’S RESPONSE | ||
| SIGNATURE | DATE | |
| If the grievance was not settled at Step III, contact your Association representative regarding an appeal option. | ||
