RESTRICTED – staff (when completed)
GRIEVANCE
Grievance: Formal Stage
Please complete, sign and send direct to your line manager or refer to paragraph 4.11 of the
Grievance Resolution Procedure
All information relating to Grievances is stored according to the Protective Marking Policy
(I13) for ‘RESTRICTED’ documents. Statistical information is provided in quarterly
returns to the Home Office and in management reports. Personal information will not be
disclosed.
For contact your Human Resource Adviser
To: ...................................................................................................................…
Reference:
(name of Line Manager)
Grievance Notification to Line Manager
This is formal notification of a Grievance. Please endeavour to resolve the issues raised,
and give your response to the individual within 10 working days of receipt of this notice.
For further advice on the Grievance Procedure please refer to Force Policy, or contact
Human Resources at the Business Centre in Kent on 830, or in Essex on 166 166.
From: .......................................................................…………………………….. (your name – aggrieved party)
Force No. ................................................
Date:
................................................
The information in this section is required for statistics only and should be filled
out by the aggrieved individual.
Issue(s) being raised:
Please tick which box most closely describes the nature of your Grievance:
Victimisation
Harassment
Bullying
Disability Discrimination
Sex discrimination
Selection
Terms & Conditions of Employment
Racial discrimination
Staff Appraisal
Other (specify)
_______________________________
Is the complaint about an individual?
Yes
If YES, is that individual
Male
Police
Female
Police Staff
Specials
No
Under 25
25 - 40
Over 40
Colleague
Supervisor
Senior Management
Outline the Grievance:
Please give the name (if about an individual) of the other party, the nature of your complaint, specific
incidents if possible, dates and times when incidents occurred, names of any witnesses to these
incidents (please continue on a separate sheet if necessary)
Policy No.
Form No. 3007 rev Dec 2010 {erev 7/12 ] v4.3
RESTRICTED – staff (when completed)
GRIEVANCE
RESTRICTED – staff (when completed)
GRIEVANCE
Describe any action already taken: (informal resolution meeting)
Attempts to resolve informally, name of the Supervisor who gave you advice and support (please
continue on a separate sheet if necessary).
Describe your expectations of the Grievance resolution process:
What you expect the outcome to be and any actions you would like to see taken (please continue on a
separate sheet if necessary).
I declare that the information l have provided on this form is the truth to the best of my knowledge.
Signed: ........................................................................................................
Print Name: .......................................................................................
Contact Telephone Number
...................................................
NB: This form should now be passed onto your Line Manager
Policy No.
Form No. 3007 rev Dec 2010 {erev 7/12 ] v4.3
RESTRICTED – staff (when completed)
GRIEVANCE