"Dispute Resolution Appeal Form" - Arkansas

Dispute Resolution Appeal 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 "Dispute Resolution Appeal Form" - Arkansas

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DEPARTMENT OF FINANCE AND ADMINISTRATION
Print Form
Office of Personnel Management
Dispute Resolution Appeal Form
Clear Form
Agency/Board/Commission
Employee's Name
Job Title
Immediate Supervisor's/Charged Party's Name
Phone Number
Grievance Officer
This form is to be used if and when the employee wishes to appeal the agency's decision on the disposition of a grievance.
All questions must be answered. (Attach additional pages, if necessary)
(1) Why is the grievance decision being appealed?
(2) What specific remedy do you request on appeal?
(3) I request as my first appeal step:
Mediation
Appeal Hearing before SEGAP
Employee Signature
Date
OPM Dispute Resolution Appeal (07/01/2014)
DEPARTMENT OF FINANCE AND ADMINISTRATION
Print Form
Office of Personnel Management
Dispute Resolution Appeal Form
Clear Form
Agency/Board/Commission
Employee's Name
Job Title
Immediate Supervisor's/Charged Party's Name
Phone Number
Grievance Officer
This form is to be used if and when the employee wishes to appeal the agency's decision on the disposition of a grievance.
All questions must be answered. (Attach additional pages, if necessary)
(1) Why is the grievance decision being appealed?
(2) What specific remedy do you request on appeal?
(3) I request as my first appeal step:
Mediation
Appeal Hearing before SEGAP
Employee Signature
Date
OPM Dispute Resolution Appeal (07/01/2014)