Complaint Form Test Complaint/Incident Form Today's Date * Incident Date * First Name * Last Name * Job Title * Grade (GS) Agency/Center/Office * Work Phone Work Email * Personal Email Duty Hours Suspected Violations * Provisions of the Collective Bargaining Agreement Provisions of your Office's Local Agreements Personal Bias Union Activity Alleged Poor Performance Complaint * Remedy Sought * Have You Talked to your Direct Supervisor About It? * Yes No If yes, please briefly describe the encounter. Name of your Direct Supervisor Have You Consulted with any other Management Officials About It? * Yes No If yes, please briefly describe the encounter. Have you Submitted your Complaint to Management in Writing and/or Email? * Yes No By agreeing below, I 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 Additional Comments If you are human, leave this field blank. Submit
