Employment and Labour Relations (General) : G.N. No. 47 (Contd.)

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Employment and Labour Relations (General)

G.N. No. 47 (contd.)

CMA F.1

REFERRAL OF A DISPUTE TO THE COMMISSION FOR MEDIATION AND ARBITRATION

(Made under Regulation 34(1))

DETAILS OF EMAIL AND PHYSICAL ADDRESS, TELEPHONE NOS. AND FAX


NOS. OF HEAD OFFICE AND AREA OFFICES OF THE COMMISSION TO BE
INSERTED HERE

READ THIS FIRST:

A. PURPOSE OF THE FORM

This Form shall be completed if a party to a labour dispute intends to refer to dispute to the Commission in terms of
section 86(1) of the Employment and Labour Relations Act.

B. WHO FILLS IN THE FORM?

The party wishing to refer the dispute – e.g. an employer, employee, union or employer’s’ organization – must
complete this form.

C. WHERE DOES THE FORM GO?

To the other party or the dispute and a copy to the Commission in the area where the dispute has arisen, together with
proof of the Form having been served on the other party or parties.

D. HOW CAN THE FORM BE SERVED?

By hand, registered post or fax. Proof of service on any other party must accompany the Form served on the
Commission. The following constitutes proof on service.
 by hand: - receipt signed by the party or a person who appears to be at least 18 years old and in charge of the
party’s place of residence or place of employment, or a signed statement by the person who served the document;

 by registered post:- proof of posting from postal authorities;

 by fax: fax transmission slip confirming the fax was successfully transmitted.

E. WHAT HAPPENS WHEN THE FORM IS SUBMITTED?

The Commission shall refer the dispute to mediation and advise all parties of the place, date and time of the first
mediation meeting. Provide that the Commission may in certain circumstances refer the dispute direct to arbitration in
terms of section 88 (3) of the Employment and Labour Relations Act.

IMPORTANT

THE RULES FOR MEDIATION AND ARBITRATION PUBLISHED BY THE


COMMISSION REQUIRE A DISPUTE CONCERNING THE TERMINATION OF
EMPLOYMENT TO BE REFEREED TO THE COMMISSION WITHIN 30
DAYS OF THE TERMINATION OR THE DATE THAT THE EMPLOYER MADE A FINAL
DECISION TO TERMINATE OR UPHOLD THE DECISION TO TERMINATE. ALL
OTHER DISPUTE TO BE REFERRED WITHIN 60 DAYS OF THE DISPUTE HAVING
ARISEN. IF THIS DISPUTE IS REFERRED OUTSIDE THE TIME PERIODS
STIPULATED, AN APPLICATION FOR CONDONATION FROM A PARTY TO THE
DISPUTE SHALL ACCOMPANY THIS FORM. OTHERWISE THIS DISPUTE SHALL
NOT BE PROCESSED

Tick the correct box 1. DETAILS OF PARTY


REFERRING THE DISPUTE
If you are an employee fill in (a) As the referring party, are you:
below

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Employment and Labour Relations (General)
G.N. No. 47 (contd.)

If you are an employer, union An employee


official or representative or an
employers’ organization, fill in
(b) below
An employer
A union official or representative
An employers’ organisation

(a If the referring party is an employee


)
Surname:
Fist Name:
Employee Identity Number:
Postal address:

Physical address:

Tel.: Cell:
Fax.: Email:

(b If the referring party is an employer, an employer,


an employer’s organization or union
Name:
Postal address:
Physical address:
Tel.: Cell:
Fax.: Email:
Contact person:

Tick the correct box 2. DETAILS OF THE OTHER


PARTY (TO THE DISPUTE)

If there is more than one other An


party, write the details of the employee
additional parties on a separate An
employer
page and staple it to this form A union
An employers’ organization
Name:
Postal addres:
Physical address:

Tel.: Fax:
Cell: Email:
Contact Person:

Tick the correct box 3. NATURE OF THE DISPUTE


Application/interpretation/
implementation of any law or
agreement relating to employment
Negotiations about terms and
conditions of employment
Discrimination
Termination of employment
Organization rights
Recognition as exclusive bargaining
agent
Disclosure of information
Tort
Breach of contract

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Employment and Labour Relations (General)
G.N. No. 47 (contd.)

Other (please describe)

If the dispute concerns


termination of employment
complete Part B of this Form
Summaries the facts of the dispute you are
referring (unless this is a termination
dispute, in which case complete Part B of
this Form)

If applicable, insert the amount If this dispute is about a claim you are
owed money, state the amount you believe
you are owed:

The dispute arose on:


(give the date, day, month
and year)
The dispute arose where:
(give the City/Town in which
the dispute arose)

Suggest a fair solution to the 4. OUTCOME OF MEDIATION


dispute
What outcome do you seek?

Tick the correct box 5. INDUSTRY


Is the dispute in an essential Yes
service
No
Indicate the sector or service in which the dispute arose.
Agriculture
Building & Construction
Cleaning
Communications
Contract
Distribution
Domestic
Financial Services
Food & Beverage
Health
Mining
Private Security
Public Service
Retail Sector
Textiles
Transport
Other (Please describe)

6. SPECIAL

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Employment and Labour Relations (General)
G.N. No. 47 (contd.)

FEATURES/ADDITIONAL
INFORMATION
The commissioner provides (a Interpretation Service
interpretation services for official )
languages only.

Parties may, at their own cost, Do you require an interpreter at mediation?


bring interpreters for languages YES
other than official languages.
NO
If yes, please indicate for what language:

Special feature might be the (b Other


urgency of the matter, the large Briefly outline any special
number of people involved, features/additional information the
important legal or labour issues Commissioner needs to note:
etc.

7. APPLICATION FOR CONDONATION


A dispute concerning termination of (a) Is an application for condonation for late filing
employment to be referred to the of this dispute necessary? Tick the appropriate
Commission within 30 days, and box
other disputes within 60 days of the YES
dispute having arisen
NO
If yes, an application for Condonation Form
shall be attached.

Proof that a copy of this form has 8. INFORMING THE OTHER PARTY
been sent could be:
 A registered slip form the Post I confirm that a copy of this form has been sent to the
Office other party/parties to the dispute and proof of this is
 A signed receipt if hand attached to this form
delivered
 A signed statement by the
person delivering the form
 A fax slip

Signature Name Position Date

PART B
ADDITIONAL FORM FOR TERMINATION OF EMPLOYMENT DISPUTES ONLY

Termination disputes shall be (1) COMMENCEMENT OF THE EMPLOYMENT


referred (i.e. received by the
Commission) within 30 days. When did you start working for your employer?
If you are outside this period,
you are required to apply for
condonation.

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Employment and Labour Relations (General)
G.N. No. 47 (contd.)

(2) NOTICE OF TERMINATION


Please give the date of your termination

How were you informed of your termination?


By letter
At/After a disciplinary hearing
Verbally
Other (please describe)

REASON FOR TERMINATION


(3)
Why was your employment terminated?
Misconduct
Operation requirements (retrenchment)
Incapacity
Incompatibility
Unknown
Other (please describe)

(4) FAIRNESS/UNFAIRNESS OF TERMINATION

(a) Procedural Issues


Do you feel that the termination was
procedurally unfair? (i.e. not in terms of a
fair procedure)
YES
NO

If yes, why?

(b Substantive Issues
Do you feel that the reason for termination was unfair?

YES
NO

If yes, why?

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