Protected when completed

Department use only

Please note:
In accordance with PSLRA s. 207, all departments and agencies within the core public administration have an informal conflict management system (ICMS) in place. Its existencedoes not affect an employee’s right to file a grievance. However, managers, employees and bargaining agent representatives are encouraged to use the ICMS when appropriate, atany stage of the grievance process, in an attempt to informally address workplace differences.

Section 1

To be completed by the bargaining agent representative



Grievance details: statement of the nature of each act or omission or other matter giving rise to the grievance that establishes the alleged violation or misinterpretation,including, as the case may be, a reference to any relevant provision of a collective agreement or arbitral award.


Date on which each act, omission or other matter giving rise to the grievance occurred


Corrective action requested

Section 2

To be completed by immediate supervisor or local officer in charge

Along with this grievance presentation form, the bargaining agent must submit a completed PSLRB form 19 "Consent of Aggrieved Employees to the Presentation of a Group Grievance".

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