Date: Your name: Your manager

---

Date: Your name: Your manager: My grievance is about: Terms & Conditions Discrimination and/or Harassment Health & Safety General I have tried to raise my concerns informally This is a stage one grievance – the first time I’ve raised this concern formally This is my stage two grievance - I am not happy with the outcome of the first stage

Tell us why you want to raise a formal grievance (use separate sheet if necessary):

Please refer to the grievance policy on OurTesco for more information. This form will be kept on your personnel file.