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Click ‘Get Form’ to open the STATEMENT OF OCCURRENCE in the editor.
Begin by entering your NAME and EE ID# in the designated fields at the top of the form.
Fill in your ADDRESS and RATE OF PAY, ensuring all information is accurate for processing.
Provide your WORK LOCATION, SENIORITY DATE, and both WORK and HOME TELEPHONE NUMBERS.
Complete the DEPARTMENT and TITLE sections to clarify your position within the organization.
Enter your SUPERVISOR’S NAME and PHONE NUMBER for reference during the grievance process.
In the statement section, clearly describe the facts concerning your grievance, including dates and relevant articles from the Working Agreement.
If necessary, use additional pages to provide a comprehensive account of events related to your grievance.
Sign and date at the bottom of the form to validate your statement before submission.
Lastly, if applicable, complete the RELEASE OF PERSONAL AND/OR MEDICAL RECORDS section for further processing.

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