621—17.4(20,70A) Content of appeal.

1. 17.4(1)  The appeal shall contain the following:

   1. a. Name, address, telephone number, and email address of the appealing employee;
   2. b. Name of agency/department by which the appealing employee is/was employed;
   3. c. A brief statement of the reasons for the employee’s appeal;
   4. d. A statement of the requested remedy;
   5. e. The name, address, telephone number, and email address of the appealing employee’s representative, if any;
   6. f. The signature of the appealing employee or employee’s representative;
   7. g. A statement of whether the employee requests a hearing open to the public; and
   8. h. A statement of whether the employee filed a complaint with the office of ombudsman and the date of the filing, if applicable.
2. 17.4(2)  Completion of the State Employee Whistleblower Action Appeal Form shall constitute compliance with all of the requirements in subrule 17.4(1).

[ARC 4459C, IAB 5/22/19, effective 6/26/19]