Telephone Number Email Branch details Branch Service 00000 Number/ Code Group Branch Name Address 1 Address 2 Town/City County Postcode Telephone Number Details of action taken If the complaint is a grievance matter, please confirm whether the member’s complaint has been put in writing to the employer. If not, please member’s explain the reason for not doing so. Otherwise please enter the date of the letter to the employer and attach a copy to this form. Date of letter
Telephone Number Email Branch details Branch Number/ Code 00000 Service Group Branch Name Address 1 Address 2 Town/City County Postcode Telephone Number Details of action taken If the member’s complaint is a grievance matter, please confirm whether the member’s complaint has been put in writing to the employer. If not, please explain the reason for not doing so. Otherwise please enter the date of the letter to the employer and attach a copy to this form. Date of letter
24627_CaseFormAugust2017_LARGEPRINT.docx