Description of Grievance:

Limit of 2000 characters

More in-depth information will be collected at the first meeting with your representative.

Any Documentation:

If none, write "none"

Identify disposition of documents: For Example:

Letter of Caution (copy on hand)  or

Letter of Counseling (Supervisors file) etc.

Remedy Requested:

*note: not all remedies are appropriate, your representative will provide explanations / aleternatives if your remedy is not appropriate.

By signing my name in the box below, I give consent to the Federal Police Officers of Hawaii and Affiliates (FPHA) to use the information I provided herein to pursue a grievance or other appropriate resolution as deemed appropriate by the FPHA. I further consent to having this information shared with appropriate representatives of the FPHA in the pursuit of a resolution.

Type your name in the box to the right to digitally sign the consent agreement above.