Communications Workers of America AFL-CIO LOCAL 1150
6 Harrison Street 4th Floor, New York, N.Y. 10013-2883  Unity1150@aol.com  (212) 925-6650
______________________________________________________________________________
Vincent A. Whitley                                Nancy M. Brett                              Robert S. Swanson
President                                                   Vice President                                     Secretary-Treasurer
Notification of Grievance, Step                               Notification Date:

Grievance Number:

     In accordance with Article 9 of the 2005 Contract, you are hereby notified of the Union's

intent to process a grievance.

Grievant Name:                                                     Job Title:

N.C.S.D:                                                              Department:

City:                                     Work Location:                                              State:

Incident Date:                                                       Article(s) Violated:

Issue Grieved:


Settlement Expected:


Print Name:________________________           Print Name:_______________________
                     (Local 1150 Representative)                                                            (AT&T Representative)

                 ________________________                           _______________________
                               (Title)                                                                                          (Title)

                 ________________________                           _______________________
                          Telephone Number                                                                     Telephone Number
                                                                      Signature:_________________________