CONNECTICUT COUNCIL OF POLICE UNIONS #15 AFSCME, AFL-CIO

OFFICIAL REQUEST FOR FILING FORM

AFSCME Local No.                           City/Town:

Date mailed to Council #15:      Local grievance number:

Name of Council #15 Staff Attorney:

1.  Please process the attached Grievance to the State Board of Mediation and Arbitration for:

    Mediation

    Full Arbitration Hearing

    Expedited Arbitration as provided for:

          in the contract

          enclosed agreement with the City/Town

Deadline to File for Arbitration:

Enclosed is filing fee Check #  for $25.00 made out to: Dept. of Labor Board will not accept grievances without a check!

2.  Please process the attached Grievance to the American Arbitration Association for:

   Mediation

   Full Arbitration Hearing

   Expedited Arbitration as provided for:

       in the contract

        enlcosed agreement with the City/Town

Deadline to File for Arbitration:

Enclosed is filing fee Check # for $200.00 made out to American Arbitration Assoc.

3.  Please attach a copy of the filled out grievance form including step responses and any and all mateirals to support this grievance.

4   Please process the attached complaint to the State Board of Labor Relations as an MPP (MUNICIPAL PROHIBITED PRACTICE)

5.  Signature of Local Union President or Union Steward