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L.E.E.B.A
Law Enforcement Employees Benevolent Association
Home
About Us
Attorneys & Legal Partners
Bargaining Units
Contact
Online Forms
DCAS Police Decertification and Authorization Form
Online Dues Assignment Card
L.E.E.B.A. Benefit Enrollment Information Sheet
L.E.E.B.A. Grievance Form for Step 1-2
Home
About Us
Attorneys & Legal Partners
Bargaining Units
Contact
Online Forms
DCAS Police Decertification and Authorization Form
Online Dues Assignment Card
L.E.E.B.A. Benefit Enrollment Information Sheet
L.E.E.B.A. Grievance Form for Step 1-2
L.E.E.B.A. Grievance Form for Step 1-2
Click here to download this form
Click here to Download this form
Full Name
Date
Title
Phone
Department
Address
Complaint Information
Complaint Information
Location of Incident
Please describe the incident in detail
If there are other who have witnessed the incident, please provide their names and phone #s
Names and Phone
Names and Phone
Names and Phone
Names and Phone
Is this the first time you raised concern about this issue Y or N
Y
N
What We Seek as Resolution?
Please provide any and all evidence pertaining to this grievance
Signature
Print Name
Send Message
