SECTION 455:10-19-43. Form

(a)   A formal grievance shall be filed with the agency grievance manager on the form prescribed by the Commission or on a form adopted by the appointing authority which addresses the specific needs of the agency.

(b)   The formal grievance form shall include, as a minimum:

(1)   the name, address and work telephone number of the employee;

(2)   the classification of the employee;

(3)   the work location, department, division or section of the employee;

(4)   the name of the supervisor with whom the employee discussed the dispute and the date of the discussion;

(5)   the date of the alleged act or incident which is cause for the formal grievance or the date the employee became aware of the grievable issue;

(6)   a brief statement of the dispute citing such information as the reason for the grievance, persons involved, etc.

(7)   any laws, merit rules, agency policy, practice or procedures the employee believes to have been violated;

(8)   a requested remedy which the employee believes to be appropriate;

(9)   the name, address and telephone number of the employee's representative, if any;

(10)   the name, address and telephone number of the spokesperson if the grievance is from a group;

(11)   the date and signature of the employee or the spokesperson; and

(12)   a list of the names of the employees if a group grievance.

[Source: Added at 12 Ok Reg 2823, eff 7-13-95]