The employee has consented to a review of case: |1|. The following Education: |7| Cost Center/Org: |8| Grade/Step: |9| Supervisor: |10| Sec. Super: |11| information is provided to the local bargaining unit for review. Dt/Time Occurrance: |2| Injury/Illness: |3| Personnel Status: |4| Type of Incident: |12| Sex: |5| Station Number: |6|
|SUBJECT||Employee Signed CA1 or CA2 with consent|
This bulletin will be sent to the Union representatives if the employee signed a consent to release additional incident details to the union.