The Professional Institute of the Public Service of Canada
The Professional Institute of the Public Service of Canada
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Individual Grievance Presentation

Protected when completed

Department use only

  • Reference No.

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 employee

A

  • Surname
  • Given names
  • Home and work telephone No.
  • Home address
  • Job classification
  • Department or agency: CFIA
  • Branch/division/section
  • Position title (and number)
  • Work location
  • Shift
  • E-mail address
  • Collective agreement (if applicable): E1.01
  • Expiry date: September 30, 2014

B

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 a reference to, as the case may be, (i) any provision of a statute or a regulation, or of a direction or other instrument made or issued by the employer, that deals with the terms and conditions of employment and that is relevant, or (ii) any provision of a collective agreement or an arbitral award that is relevant.

I am submitting a grievance because my work description received on __ is not an official, complete and current statement of my duties and responsibilities under Article E1.01 of my collective agreement.

OR

I am filing a grievance because I have not received an official, complete and current statement of my duties and responsibilities under section E1.01.

C

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

See Instructions

D

Corrective action requested

I would like to receive a current statement of my duties and responsibilities under Article E1.01 of my collective agreement, retroactively to (Date of email to supervisor) October 2017.

  • Signature of employee
  • Date

Section 2

To be completed by the bargaining agent representative where applicable

Approval for presentation of grievance relating to a collective agreement or an arbitral award, and agreement to represent employee are hereby given

  • Signature of Bargaining Agent Representative
  • Date
  • Bargaining agent: PIPSC
  • Bargaining unit/component: CFIA-VM
  • Name of local bargaining agent representative: VALÉRIE COUPAL
  • Telephone No.: 450 836-3063   poste 224
  • Facsimile No.: 450 836-1508
  • Address for contact: 2320 RUE PRINCIPALE, ST-CUTHBERT, QUÉBEC, J0K2C0
  • E-mail address: valerie.coupal@inspection.gc.ca

Section 3

To be completed by employee where representative is not a representative of a bargaining agent

I agree to act on behalf of the employee

  • Signature of representative
  • Date
  • Name of representative
  • Telephone No
  • Facsimile No.
  • Address for contact
  • E-mail address

Section 4

To be completed by immediate supervisor or local officer in charge

  • Name and title of management representative
  • Date received
  • Signature

TBS/SCT 340-55 (2006/03)