5.05b Notice of Appeal/Request for Hearing - Exhibit

Document Type: Exhibit
Number: 5.05b
Effective: 05-01-06
Revised: 08-18-14
Legal References:


NOTICE OF APPEAL AND REQUEST FOR POST-TERMINATION HEARING

TO THE EMPLOYEE: Please note that your termination is final unless within five (5) work days after receiving the termination letter you provide a written appeal and request for a post-termination hearing to Human Resources on this form. Your written appeal must be received in Human Resources within this five (5) work day time period. Failure to comply with this time requirement shall constitute a waiver of any rights under the City of Boise’s termination procedure.

By submitting this form, you are appealing your termination and requesting a post-termination hearing. The post-termination hearing process is explained in the City of Boise’s Corrective Action Policy and Regulation. The policy and regulation are located on the City’s Inside webpage or you can contact Human Resources at 208-384-3850 for a copy.

Please indicate whether you ______ WILL or ______ WILL NOT be represented by legal counsel at the hearing before the hearing officer. 

Name of Attorney for Employee
_________________________

Telephone Number of Attorney
_________________________

Address of Attorney
_________________________


Fax Number of Attorney
_________________________


City, State, and Zip Code 
_________________________

E-mail Address of Attorney
_________________________


Employee’s Signature Date
_________________________

Employee Printed Name 
_________________________


Employee’s Address
_________________________

Employee’s Telephone Number 
_________________________


City, State, and Zip Code
_________________________

Employee’s Fax Number 
_________________________


Employee’s E-mail Address
_________________________

For Internal Use Only

Date Received in Human Resources: _________________________
Received by: _________________________

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