STAFF GRIEVANCE SUBMISSION FORM (For Teaching & Non-Teaching Staff Members) Click to view Circular STAFF DETAILSFull Name of Employee: *Employee ID / Code: *Designation: *ProfessorAssociate ProfessorAssistant ProfessorAssistant TeacherAdministrative StaffTechnical StaffOther:Other Designation *Department / Section: *Mobile Number: *Official Email ID: *GRIEVANCE DETAILSCategory of Grievance: *Service MatterWorkplace IssueAdministrative MatterLeave Related MatterSalary / Benefits MatterHarassment / MisconductInfrastructure / FacilitiesOther:Write Category *Subject of Grievance: *Detailed Description of Grievance: *(Please provide complete details of your grievance.)SUPPORTING DOCUMENTSUpload Supporting Documents (if any): *Appointment LetterEmail CommunicationOffice OrderOther Relevant DocumentsAttachment *Drag and Drop (or) Choose FilesEXPECTED RESOLUTIONRelief / Resolution Expected:DECLARATIONI hereby declare that the information provided above is true and correct to the best of my knowledge. I understand that the Staff Grievance Redressal Cell may seek additional information if required for proper investigation and resolution of the grievance.Consent *I agree to the above declaration.Date *DaySelect day12345678910111213141516171819202122232425262728293031MonthSelect month123456789101112YearSelect Year212621252124212321222121212021192118211721162115211421132112211121102109210821072106210521042103210221012100209920982097209620952094209320922091209020892088208720862085208420832082208120802079207820772076207520742073207220712070206920682067206620652064206320622061206020592058205720562055205420532052205120502049204820472046204520442043204220412040203920382037203620352034203320322031203020292028202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926Place *Signature of Employee: *FOR OFFICE USE ONLYGrievance Reference No.:Date of Receipt:DaySelect day12345678910111213141516171819202122232425262728293031MonthSelect month123456789101112YearSelect Year212621252124212321222121212021192118211721162115211421132112211121102109210821072106210521042103210221012100209920982097209620952094209320922091209020892088208720862085208420832082208120802079207820772076207520742073207220712070206920682067206620652064206320622061206020592058205720562055205420532052205120502049204820472046204520442043204220412040203920382037203620352034203320322031203020292028202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926Received By:Status:Under ReviewInformation RequiredResolvedClosedRemarksStaff Grievance Redressal CellLokbharati University for Rural Innovation, Sanosara "Committed to Fairness, Transparency and Employee Welfare"Submit
