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Grievance Form

VA FACILITY ___Des Moines VAMC, Manhattan VAMC, Brooklyn VAMC, Tuscaloosa VAMC,

Dayton VAMC, Atlanta VAMC, Lake City VAMC, Jessie Brown VAMC, Hines VAMC, North Chicago VAMC, Buffalo VAMC

DATE OF OCCURRENCE __Ongoing______

CONTRACT ARTICLE VIOLATED _Article 43, Section 3 A 3 ______

DETAILS (USE ADDITIONAL SHEET IF NECESSARY) __After repeated requests Management refuses to comply with providing an “additional copy of the listing to the local UAN office containing the following information: a) The name of the RN and the anniversary date of the effective date of the dues withholding and b) Identification of active RNs for whom allotments have been temporary stopped and identification of those which are a final deduction because of termination”

REMEDY REQUESTED _Management immediately start provided a copy of the list to local UAN/NNU offices.

SIGNATURE___Irma L. Westmoreland, RN Chair NNU-VA___ DATE____10-8-10__