Get Whistleblower Retaliation Complaint Form 5-19-15 - Evc Uci

Completing the Whistleblower Retaliation Complaint Form 5-19-15 - Evc Uci is an important process for anyone who believes they have experienced retaliation as a UCI employee or applicant. This guide will provide clear and detailed steps to assist users in filling out this form accurately and effectively.

Follow the steps to complete the form online effectively.

1. To begin, click the ‘Get Form’ button to access the Whistleblower Retaliation Complaint Form, ensuring it opens correctly in your browser.
2. In the 'Complainant' section, fill in your name, job title, department, location, mailing address, and telephone number. Ensure that all information is accurate and up to date.
3. If applicable, include details for a 'Complainant's Designated Representative' by providing their name, job title, mailing address, and telephone number.
4. For the 'Accused Employee(s)' section, list the names of individuals or entities you believe have retaliated against you, along with their department and their relationship to you.
5. Proceed to section I, 'Protected Disclosure.' Here, describe the disclosure that prompted the retaliation, indicating to whom it was made and the date. If your complaint involves a refusal to obey an illegal order, skip to section II.
6. In section II, 'Refusing to Obey an Illegal Order,' describe the illegal order, including who issued it, your response, and the dates associated with this event.
7. For section III, 'Alleged Retaliation,' detail the adverse personnel actions taken against you, the individuals responsible, and the dates these actions occurred.
8. In section IV, explain why you believe that your protected disclosure or the refusal to obey the illegal order contributed to the adverse actions mentioned in the previous section.
9. If there are any related actions or grievances, fill out section V, noting the type of proceeding, case number, initiation date, and current status.
10. Initial the grievance rights statement to acknowledge your understanding of potential personnel grievance rights.
11. Finally, sign and date the declaration to affirm the truthfulness of your statements. Include the county and U.S. state where signed before submitting the form.
12. Review all provided information for accuracy. Once completed, you may download, save, or share the form as required.

Submit your Whistleblower Retaliation Complaint Form online today to begin the process.