GRIEVANCE FACT SHEET
(For OPEIU Local 107 Use Only)

This form is to be filled out by a Union Steward or Other Elected Union Official and attached to the Union Copy of the Grievance Form.

Case Number:

Employer: Bristow Group / Bristow US LLC / et al

Employee Name & Number: ______________________________

Supervisor or Management Involved: ______________________________

Incident Details:








Signature of Grievant(s): ______________________________


Company Position - Please Print:







Union Position - Please Print:







List of Witnesses, Attach Statements Separately:

______________________________

______________________________

______________________________

______________________________
Signature of Union Steward or Union Official & Date: ______________________________