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CONCILIATION SERVICE DISPUTE REFERRAL
(an offline version of this form is also available)
COMPANY
SPOKESPERSON / REPRESENTATIVE
ADDRESS
TELEPHONE
FAX
EMAIL
NATURE OF COMPANY BUSINESS
APPROX. NO. OF EMPLOYEES (Total)
   
EMPLOYEE DETAILS
EMPLOYEES REPRESENTED BY
(e.g. Union if involved)
SPOKESPERSON
ADDRESS
TELEPHONE
FAX
EMAIL
DETAILS OF OTHER PARTY
(e.g. union if involved)
NAME OF OTHER PARTY
(e.g. Union if involved)
SPOKESPERSON
ADDRESS
TELEPHONE
FAX
EMAIL
OTHER UNION(s) / PARTIES INVOLVED
 
WORKER DETAILS
NUMBER OF WORKERS INVOLVED IN THIS DISPUTE
CATEGORY OF WORKERS
 
DISPUTE DETAILS Check all that apply.
Adoptive Leave Allowances
Atypical piece work Basic Pay Negotiable
Basic Pay reductions Basic pay standard
Basic Special increases Bonus
Bullying & Harrassment Change in work practices
Change of Ownership Christmas
Conditions of Employment Deductions
Demarcation Differentials
Disciplinary action/Procedures Dismissal
Disturbance/relocation Employee Share ownership
Equality/discrimination European works council
Force Majeur Leave Gain/Profit sharing
Grading/Regrading Health & Safety Leave
Holiday Pay Holidays
Hours of Work Income Continuance/PHI
Involve in legal case against Emp Job Specification/Job evaluation
Lay off principles Lay off selection
Lay off terms Loss of earnings
Manning Levels/Staffing Maternity leave/pregnancy
Minimum Notice Minimum Wage
No written Contract Overtime Allocation
Overtime loss of earnings Overtime premium rates
Paternity Leave Pay
Pay increase Pension Scheme Intro
Pension Scheme Terms Permancy/work Contracts
Productivity Public Holidays
Redundancy principles Redundancy selection
Redundancy Terms Re-employment
Replacement Restructuring/Rationalisation
Rosters Salary Scales
Seniority Service Pay
Severance principles/selection/terms Shift Allocation
Shift Introduction Shift loss of shift
Shift Premium rates Sick pay scheme intro
Sick pay terms Special Leave
Staff discounts/incentives transfer of undertakings
Trave & Subsistance/exp Unfair redundancy selection
Union activity Union management agreement
Union recognition Union representation
Use of Contractors Working Time Act
ADDITIONAL COMMENTS
 
REFERRED BY
EMAIL
DATE
Enter Verification Code
Image Verification Code Image Verification
 





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Labour Relations Commission, Tom Johnson House, Haddington Road, Dublin 4, Ireland.
TEL +353 1 6136700 FAX +353 1 6136701 EMAIL info@lrc.ie