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Complaint Form Pdf Download
Human Resources
H. Complaint Review Step I
Date Received:
Date of Response:
Decision Attached:
Signature of Step I Reviewer:
Email Address:
Printed Name and Title:
Work Phone No.:
I. Complaint Review Step II
I do not accept and appeal
to Step II (state reason below)
Complainant’s Signature:
Date:
I request Administrative Review
I request Factfinding
Reason(s) for appeal and unresolved issue(s):
Date Received:
Date of Response:
Decision Attached:
Signature of Step II Reviewer:
Email Address:
Printed Name and Title:
Work Phone No.:
J. Complaint Review Step III
I do not accept and appeal to Step III
(state reason below)
Complainant’s Signature:
Date:
I request a University Hearing Officer
I request a Non-University Hearing Officer
Reason(s) for appeal and unresolved issue(s):
PPSM 70 Complaint Form
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source: hrweb.berkeley.edu
Complaint Form Pdf Download
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