"Administrative Record Tracking Form" - Arkansas

Administrative Record Tracking Form is a legal document that was released by the Arkansas Department of Finance & Administration - a government authority operating within Arkansas.

Form Details:

  • Released on July 1, 2014;
  • The latest edition currently provided by the Arkansas Department of Finance & Administration;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Arkansas Department of Finance & Administration.

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Download "Administrative Record Tracking Form" - Arkansas

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ADMINISTRATIVE RECORD TRACKING FORM
Type of Grievance
Date Received by OPM
Grievant:
Address:
Phone Number:
E-mail Address
Grievant Attorney/Representative:
Address:
Phone Number:
E-mail Address
Agency:
Charged Party/Supervisor:
Address:
Phone Number:
E-mail Address
Agency Attorney:
Address:
Phone Number:
E-mail Address
Grievance Officer:
Phone Number:
E-mail Address
OPM Use Only
Hearing Date:
Reschedule Date:
Hearing Time:
Reschedule Time:
a.m.
p.m.
a.m.
p.m.
Panel:
Chair:
SEGAP Result:
Panel Member:
CFO Result:
Panel Member:
7/1/2014
ADMINISTRATIVE RECORD TRACKING FORM
Type of Grievance
Date Received by OPM
Grievant:
Address:
Phone Number:
E-mail Address
Grievant Attorney/Representative:
Address:
Phone Number:
E-mail Address
Agency:
Charged Party/Supervisor:
Address:
Phone Number:
E-mail Address
Agency Attorney:
Address:
Phone Number:
E-mail Address
Grievance Officer:
Phone Number:
E-mail Address
OPM Use Only
Hearing Date:
Reschedule Date:
Hearing Time:
Reschedule Time:
a.m.
p.m.
a.m.
p.m.
Panel:
Chair:
SEGAP Result:
Panel Member:
CFO Result:
Panel Member:
7/1/2014