Document text
Date: [DD MONTH YYYY]
Sent by [E-MAIL / POST / HAND DELIVERY]
To:
[EMPLOYER'S NAME — COMPANY OR PERSON]
Attention: [MANAGER / HR / OWNER]
[ADDRESS OR E-MAIL]
From:
[YOUR FULL NAME]
[ADDRESS]
[PHONE] · [E-MAIL]
Subject: Personal grievance — [YOUR NAME], [JOB TITLE]
Dear [NAME],
I am raising a personal grievance under the Employment Relations Act 2000. I want you to address it.
1. My employment
Detail Information
Job title [JOB TITLE]
Start date [DATE]
Employment ended (if it has) [DATE / STILL EMPLOYED]
Hours and pay [HOURS PER WEEK] · $[AMOUNT] per [HOUR / YEAR]
Employment agreement [INDIVIDUAL / COLLECTIVE — NAME AND DATE]
2. The grievance
I claim that: [KEEP WHAT APPLIES, DELETE THE OTHERS]
Unjustified dismissal. I was dismissed on [DATE]. [E.G. NO REASON WAS GIVEN / I WAS NOT TOLD OF THE CONCERNS OR GIVEN A CHANCE TO RESPOND / THE PROCESS WAS UNFAIR].
Unjustified disadvantage. My employment was affected to my disadvantage by an unjustified action: [E.G. HOURS CUT FROM (X) TO (Y) ON (DATE) / DEMOTION / UNFAIR WARNING / SUSPENSION WITHOUT PROCESS].
Discrimination on the ground of [GROUND].
Sexual harassment by [ROLE OF PERSON, NOT NECESSARILY A NAME] on or about [DATES].
Racial harassment on or about [DATES].
Adverse treatment because I am, or am thought to be, affected by family violence.
3. What happened
Date What happened Who was involved Evidence
[DATE] [SHORT FACT] [ROLE] [E-MAIL / TEXT / ROSTER / PAYSLIP / WITNESS]
[DATE] [SHORT FACT] [ROLE] [EVIDENCE]
[DATE] [SHORT FACT] [ROLE] [EVIDENCE]
4. What I am asking for
To resolve this grievance I ask for: [KEEP WHAT APPLIES]
1. [Reinstatement to my position / withdrawal of the warning dated (DATE) / restoration of my hours].
2. Payment of lost wages from [DATE] to [DATE]: $[AMOUNT].
3. Compensation for humiliation, loss of dignity and injury to feelings: $[AMOUNT].
4. [A certificate of service / a neutral reference].
5. [OTHER].
5. Statement of reasons for dismissal
[DELETE IF NOT DISMISSED] Under section 120 of the Employment Relations Act 2000, I request a written statement of the reasons for my dismissal. Please provide it within 14 days after you receive this letter.
6. Next steps
I am willing to meet to resolve this in good faith and to attend mediation through Employment New Zealand. Please reply in writing by [DATE].
I may be represented by [NAME OF UNION / ADVOCATE / LAWYER, OR DELETE]. Please also send me a copy of my employment agreement, my time and wage records and my holiday and leave records.
Yours sincerely,
______________________________
[YOUR FULL NAME]
Attachments:
1. [EMPLOYMENT AGREEMENT]
2. [DISMISSAL LETTER / WARNING / ROSTER / PAYSLIPS]
3. [MESSAGES OR E-MAILS]
BEFORE SENDING — delete this part
Your deadline is 90 days from the date of the action or the date you found out about it, whichever is later. For sexual harassment it is 12 months. Send it early; the employer only has to be made aware of the grievance and that you want it addressed.
Keep proof of sending (sent e-mail, courier receipt).
High earners: if your annual remuneration is $200,000 or more, a grievance for unjustified dismissal may not be available (section 113A). Other grievances such as discrimination or harassment still are.
Free help: Employment New Zealand mediation, a union or a community law centre.
Field labels in [SQUARE BRACKETS, CAPITALS] must be completed or deleted. Alternatives are separated by a slash. © Layers (layers.md), licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Template, not legal advice.
Reply to this document or get a deadline reminder: https://layers.md/nz/personal-grievance-letter?from=reply-nz-personal-grievance