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Westchester, NY Merged Branch 693 National Association of Letter Carriers
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Form 8190 DRP Grievance Form

 

USPS Forms and Information Checklist

for Grievance Handling

Form No.

Name of Form and/or Description

CA-1

Employee Notice of Traumatic Injury

CA-2

Employee Notice of Occupational Disease

CA-2A

Employee Notice of Recurrence of Disability

CA-7

Claim for Continuing Compensation

CA-16

Authorization for Examination and/or Treatment

CA-17

Duty Status Report

Form 13

Office Routing Slip (Buck Slip)

Form 50

Notification of Personnel Action

Notice 11

Information for Apartment House Customers

Notice 25

Maximum Time Allowance for Routing Mall

Poster 43

Your Rights under the Family And Medical Leave Act of 1993

Notice 70

Privacy Act Notice

Publication 71

Notice for Employees Requesting Leave for Conditions Covered by FMLA

Notice 76

Expanded Vehicle Safety Check

OF 346

U.S. Government Motor Vehicle Operator's Identification Card (obsolete)

SF 46

U.S. Government Motor Vehicle Operator's Identification Card

SF 91

Operator's Report of Motor Vehicle Accident

SF 94

Statement of Witnesses

SF 95

Tort Claim

313

Requisition for Printed Carrier Case Labels

1017-A

Time Disallowance Record

1017-B

Unauthorized Overtime Record

1164

Mileage and Parking

1187

Dues Withholding -- Regular Member

1188

Revocation of Voluntary Authorization for Dues Withholding

1189

Dues Withholding -- Retirees

1192

Authorization for Purchase of U.S. Savings Bonds

1216

Employee's Current Mailing Address

1223-A

Earnings Statement

1221

Advanced Sick Leave Authorization

1224

Court Duty Leave Statement

1230

Time Card

1230-A

Time Card -- Week 1

1230-B

Time Card -- Week 2

1230-C

Other Duty Card

1234

Trip Card

1260

Non-Transactor Card

1261

Non-Transactor Report

1311

Carrier Transportation Agreement

1375

Employee Identification Card

1507

Request to Provide Proper Mail Receptacle

1512

Delivery Service Notice

1564

Address Change Sheet

1564-A

Carrier Route Book -- Route Instructions

1564-B

Orders to Box Section or Other Special Orders

1571

Report of Undelivered Mail, Etc.

1621

Carrier Route Report

1623

Change in Delivery, Relay and Collection

1627

Analysis of Curtailed Mail

1627

Analysis of Auxiliary Assistance and Overtime on Route

1627

Analysis of Auxiliary Routes

1627

Analysis of Late Leaving

1639

Carriers Report of Mis-sorted Mail

1700

Vehicle Accident Investigation Worksheet

1700

Vehicle Accident Worksheet

1709

Acceptance of Medical Treatment at USPS Medical Facility

1717

Bid for Preferred Assignment

1723

Assignment Order

1750

Employee Probationary Period Evaluation Report

1767

Report of Hazard, Unsafe Condition or Practice

1768

Safe Driver Award Committee Decision

1769

Accident Report

1813

Late Leaving and Returning Report

1838

Carrier's Count of Mail (Management Summary)

1838-A

Carrier's Count of Mail -- P.P./Combination Services Worksheet

1838-B

Parcel Post Firm Delivery Worksheet

1838-C

Carrier's Count of Mail -- Letter Carrier Routes Worksheet

1839

Payment Record for Carrier Drive-out Agreements

1840

Summary of Count and Inspection -- Letter Carrier's Route

1840-A

Summary of Count and Inspection, Mail, P.P. and Combination

1840-B

Carrier Time Card Analysis

2146

Employee Claim Forms

2181

Authorization and Release of Personal Information

2188

Subrogation Receipt

2198

Accident Report -- Tort Claim

2240

Pay Adjustment Request

2243

Payroll Adjustment

2480

Driving Record

2545

PAR Case Card

2546

PAR Correspondence

2547

PAR Reports

2548-A

Training Record

2565

Formal Regional Appeal of EEO Complaint

2608

Grievance Summary Step 1

2609

Grievance Summary Step 2

2610

Grievance Summary Step 3

2800

Application for Death Benefits

2801

Application for Retirement

2801-A

Superior Officer's Statement, Application for Disability Retirement

2801-B

Physician's Statement, Application for Total Disability Retirement

2802

Application for Refund of Retirement Deductions

2806

Individual Retirement Record

2808

Designation of Beneficiary, CSRS

2809

Health Benefits Registration Form

2810

Notice of Change in Health Benefits Enrollment

2944

Receipt for Customs Duty Mail

3074

Request for Waiver of Claim for Erroneous Payment of Pay

3076

Request to Cancel or Change Salary Allotment

3189

Request for Temporary Change of Schedule

3521

Carrier's Report on House Numbers and Mail Receptacles

3546

Notice to Change Forwarding Order

3570

Notice of Attempt to Deliver Mail

3575

Change of Address Order

3579

Undeliverable 2nd, 3rd, 4th or Controlled Circulation Matter

3582-A

Postage Due Bill

3582-B

Carrier's Due Bill

3811

Return Receipt, Regular/Certified/Insured Mail

3816

COD Tag and Sender's Receipt

3821

COD, Bulk Receipt for Mail and Funds

3849-A

Delivery Notice or Receipt

3849-B

Delivery Reminder or Receipt

3867

Registered and Certified Matter Received for Delivery

3868

Carrier's Clearance Receipt

3883

Delivery Notice or Receipt

3921

Daily Volume Recording Worksheet

3922

Delivery Volume Unit Recap

3923

Daily Delivery Operation Analysis

3968

Daily Mail Collection Record

3971

Request for Leave

3972

Absence Analysis

3973

Military Leave Control

3981

Roster Sheet

3982

Change of Address (Carrier's Case)

3996

Carrier Auxiliary Control

3997

Unit Daily Summary, Record of Carrier Work Hours, Absences

3997-B

Daily Delivery Analysis

3998

Unit Summary of City Delivery Routes

3999

Inspection of Letter Carrier Routes

3999-A

Record of Deliveries -- Worksheet

3999-B

Inspection of Collection Route

4003

Official Rural Route Description

4003-A

Official Rural Route Description, Continuation Sheet

4027

Petition for Change in Rural Delivery

4098

Employee Identification Card

4239

Count of Mail (Rural Route)

4240

Rural Carrier Trip Report

4241

Rural Delivery Statistics Report

4241-A

Rural Route Evaluation

4248

Rural Route Inspection Report

4516

Emergency Vehicle Hire Use

4528

Vehicle Defect Report

4565

Vehicle Repair Tag

4570

Vehicle Time Record

4582

Operator's Record

4582-A

Summary of Driving Record

4584

Observation of Vehicle Operator

4585

Postal Driver Accident Information

4586

Accident Information

7020

Authorized Absence from Workroom Floor

****

Overtime Desired List

****

P.I.'s Reports wen they are involved

****

Record of Discipline

****

Records of Merit

****

Street Supervision Report

****

Vehicle Analyst's Report of Accident

****

Tachograph Record (or any other measuring device records currently being used)

****

WITNESSES statements of non-employees, carriers, clerks and supervisors

****

"Carrier Report - Daily" shows clock rings of carriers in the station. (Used when tmes are needed relative to route, overtime, comparisons.)

****

"Employee Time Certification" - Time used by all employees in a pay location by pay period. (Hours worked, type leave, etc.)

****

History of Clock Rings - Shows individual employee clock rings and leave for pay period

****

P/T Emplyees Weekly Cumulative Hours - By Pay Locations showing cumulative weekly-to-date- work, leave and O.T. totals for PTF's

****

Sick Leave and LWOP Usage Report Lists are employees by pay location using sick leave and LWOP

****

Quarterly print-out on sick leave use