HomeMy WebLinkAbout14Complaint Case
CORAL CONSTRUCTION COMPANY
EMPLOYEE DISCRIMINATION REPORT FORM
Employee's Name: Employee's Signature:
Project: __Employee Classification:
Job Location: Supervisor's Name: Date Filed:
Date of claimed d1acrImination:
Mature of Complaint: (General circumstances, job conditions, etc.)
Claimed Result of Discrimination: (i.e. job assignment, pay classification. etc.)
List any fellow workers who way be able to support your claim:
List persons not employed by your company that you would be willing to trust to evaluate
your complaint:
Weport of Findings: XAst specific evidence of discrimination.
List specific adverse Impact on employee.
ZAst any conditions which Impact on other employees.
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-J on V& eb a
Ong-,owmanded ActIona: List Specific steps taken (Vestltutt Of Y, 0"we f Job
assignment. employealoupervisor counseling. arbitration. etc.)
Acknowledgement of employee: Report finding and recommendations discussed with employee.'
D�oea employee request further arbitration?
Employee Signature: Date: -
Investigators Signature: Date:-