MASSACHUSETTS CIVIL SERVICE COMMISSION – BYPASS APPEAL FORM
Name of Person Filing Appeal Name
of Government Agency Against
(Appellant):
Whom Relief is Sought (Respondent):
Appell
ant Street or P.O. Box: Respondent
Street or P.O. Box:
Appellant City, State, Zip Code: Respondent
City, State, Zip Code:
Appellant Contact Phone Number: Respondent
Contact Phone Number:
Appellant Email Address: Per
son who signed Bypass Letter:
Title of Civil Ser
vice Position
IRU which you were not selected:
W
as this an original or promotional appointment you were seeking?
Date you received written notification of bypass:
Have you ever filed an appeal
with the Civil Service Commission before?
REQUIRED NEXT STEPS BY A
PPELLANT
1. Attach a check or money order in the amount of $25.00 (for original appointments) or $75.00
(for promotional appointments) made payable to: Civil Service Commission.
2. Attach a copy of the written notification of bypass that you received from Respondent.
3. Mail or
hand-deliver this appeal form to the Civil Service Commission at One Ashburton
Place: Room 503, Boston, MA 02108 within sixty (60) calendar days of receiving the
notification of bypass. (For those appeals received via mail, the postmark date will be used
to determine if the appeal is timely.)
4. Mail or hand-deliver a c
opy of this bypass appeal form to the Respondent.
WHAT HAPPEN
S AFTER THE COMMISSION RECEIVES YOUR APPEAL FORM?
1. Within ten (10) days, you and the Respondent will receive an Acknowledgment Form from
the Commission along with a “Notice of Pre-Hearing Conference”. The pre-hearing
conference is usually held within thirty (30) days from the time the Commission received
your appeal.
2. You and the Respondent
DUHrequired to attend the Pre-Hearing ConferenceDWZKLFKWLPHD
member of the Commission will provide further details about how your appeal will proceed.
SIGNATURE OF APPELLANT:
TODAY’S DATE:
CSC Bypass Appeal Form Rev. 9/18/13
click to sign
signature
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