Complaint Form Submission

Personal Information
Todays Date*
MM slash DD slash YYYY
Incident Date:*
MM slash DD slash YYYY
Name*
First Last
Job Title*
Grade (GS)
Agency/Center/Office*
Duty Hours
Work Phone
Personal Phone
Work Email*
Personal Email*
Complaint / Incident Information
Suspected Violations*
- Provisions of the Collective Bargaining Agreement
- Provisions of your office's local agreements
- Personal bias
- Union Activity
- Alleged poor performance
- Alleged poor conduct
- Discrimination
Please check the box(es) that you feel your complaint or incident violates.
Complaint*
Please provide a description of the act or incident. Please include the following: 1) A description of the act or incident, including date and location; 2) Why it happened: personal bias, union activity, alleged poor performance or conduct, discrimination; 3) Name, job title, grade, work unit, organization, email and duty phone of each witness who knows the facts about the complaint.
Remedy Sought*
In one sentence, what action do you think Management should take to resolve your complaint?
Actions Already Taken
Have you talked with your direct supervisor about it?*
- Yes
- No
If yes, Please briefly describe the encounter.
Name of your direct supervisor.
First Last
Supervisor's Work Phone
Have you consulted with any other Management official(s) about it?*
- Yes
- No
If yes, Please briefly describe the encounter. Include who you talked to, including their name(s) and title(s), when you spoke to them, and what was said.
Have you submitted your compaint to Management in writing and/or email?*
- Yes
- No
If yes, please be prepared to submit, to your union steward(s), a copy of your complaint to Management and any related correspondence/documents upon request.
Do you have any additional documents you wish to provide?
Max. file size: 64 MB.
Please do not submit any PII or sensitive information. Such documents should be sent directly to a National Officer once they reach out to you.
Consent
Consent to Representation / Acknowledgement of Terms*
By agreeing below, you hereby designate NFFE Local 1998 to represent me in the above-described complaint. I understand that NFFE Local 1998 is not obligated to take my complaint to arbitration.
I Agree
Acknowledgement of BUE Right to File Your Own Grievance*
BUEs have the right to file their own grievances, and you can find more information about the grievance process in Article 20 of the collective bargaining agreement. A grievance must be filed within 30 or 45 days (depending on the situation) of when the incident happened (or when you became aware of it). Even if a BUE files their own grievance, only NFFE Local 1998 can take any complaints to arbitration, and they are not obligated to do so. By clicking "I Agree" below, you acknowledge that you are aware of this.
I Agree
Additional Comments
Items like personal preferences to how we communicate with you, privacy concerns, etc.
Untitled

Personal Information

Complaint / Incident Information

Actions Already Taken

Consent