Fillable Please Print or Type all information except Signature (Illinois)

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Please Print or Type all information except Signature (Illinois)

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The Please Print or Type all information except Signature (Illinois) form is 1 page long and contains:

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Country of origin: US
File type: PDF

BROWSE ILLINOIS FORMS

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Please Print or Type all information except Signature
Employee Name
Position Title Facility Name Agency
Work Address
Bargaining Agent (if any)
RC-23
Work Phone Home/Cell Phone
Statement of Grievance and Relief Requested (including citation of alleged rule violations).
Signature of Grievant:
Date Submitted
Date of Response
.
Employer Representative
Employee’s Signature
Date Submitted
Date of Response
Response of agency head:
Response: Accepted
Rejected
Manager’s Signature
Employee’s Signature
Date Submitted
Date of Response
Response of CMS (where applicable):
Response: Accepted
Rejected
Manager’s Signature
Employee’s Signature
Date Submitted
Decision Award:
Step 1
Step 2
Step 3a
Arbitration (3b)
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Please Print or Type all information except Signature (Illinois)

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Completed 13 August 2020

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