PETITION OF APPEAL
TO ALEXANDRIA CIVIL SERVICE COMMISSION
Regular employees in the classified service who believe they have been subjected to disciplinary actions by the Appointing Authority involving dismissal, suspension, reduction in pay or demotion or have been denied any right under the provisions of the Charter or these Rules, without just cause shall have the right to seek a hearing before the Commission to evaluate the Appointing Authority’s actions and to determine whether the Appointing Authority had just cause and acted in good faith in taking the action. The burden of proof on appeal, as to the facts, shall be on the Appointing Authority.
A regular employee who is removed while serving a working test period following promotion and who is denied reinstatement in his former position, as provided in Rule VII§10.5, may appeal to the Commission.
Persons who have applied for or have been examined for the classified service and who allege they have been discriminated against due to race, color, national origin, gender, sexual orientation, religion, age, disability, politics, lack of just cause, favoritism, or arbitrary reasons or other valid reasons unrelated to merit-employment considerations shall have a right to appeal to the Commission.
Attached is a Petition of Appeal that must be completed by any person filing an appeal to be heard by the Alexandria Civil Service Commission. Although the person need not use this form to begin his appeal, the petition for an appeal must be in writing and contain all of the information listed under Rule XIII§1.5.A.
Rule XIII (Appeals, Hearings, and Investigations) provides detailed instructions for filing an appeal, lodging a complaint, or requesting an investigation. It also provides important deadlines, as well as the procedures governing the process. We urge you to read the Rule to ensure you have an understanding of the requirements. You can obtain a copy of this Rule from the Civil Service Department or access it on the City’s website by:
- Going to http:web.cityofalex.com.
- Go to “Civil Service” located on the left-hand side of the page and click.
- Click on “Rules and Forms”.
- Click on “Rule XIII – Appeals, Hearings, & Investigations”.
Should you have any questions or require assistance, please do not hesitate to call 449-5021.
Thank you.
Pam Saurage,
Assistant Director of Civil Service
Docket No. ______
PETITION OF APPEAL
TO ALEXANDRIA CIVIL SERVICE COMMISSION
(Civil Service Rules Governing the Appeal Procedure
Are Available Upon Request.)
Name: ______Employee No: ______
First Middle Initial Last
Address: ______
Street and Number or P.O. Box City State Zip Code
Phone Numbers: (___)______(___)______(___)______
Work Home Cell
In accordance with the provisions of the City of Alexandria Civil Service Rules, I hereby appeal to the Civil Service Commission from any action(s) taken against me as a classified City employee, as follows:
[___] I was dismissed [___] I was suspended
[___] I was demoted [___] I was allocated / reallocated [___] My salary was reduced [___] I was denied a salary increase
[___] I am working outside my [___] My job classification assigned classification is incorrectly graded
[___] I was denied a promotional [___] I was denied reinstatement to opportunity my former position
[___] My hours have been reduced[___] I was rated incorrectly on my
to less than 40 per weekperformance evaluation
[___]Other, please give a brief explanation in the space below:
______
I learned about the action taken against me on: _____/_____/_____
Month Day Year
Effective date of the action taken:_____/_____/_____
Month Day Year
On the above date, I am/was employed by: ______
Name of Department
My job title is/was: ______, and my civil service status is/was [___]Permanent [___]Probationary [___]Other
The name and title of the person who authorized the action taken against me is:
______
Person’s NameTitle of Person
I hereby request the Commission hear my appeal and (state below what action you want the Commission to take on your behalf)
______
Because (briefly explain below why you feel the action or decision was unjust and the Commission should do what you are requesting)(attach additional pages, if necessary)
______
APPEALS BASED ON ALLEGED DISCRIMINATION
Failure to provide all requested information in this section may jeopardize your appeal.
Certain discriminatory actions are appealable only if you allege that action taken against you resulted from discrimination due to race, color, national origin, gender, sexual orientation, religion, age, disability, politics, lack of just cause, favoritism, or arbitrary reasons or other valid reasons unrelated to merit-employment considerations.
Civil Service Rule XIII§1.5.F provides that where discrimination is alleged to be a basis for appeal, specific facts supporting the conclusion of discrimination must be alleged in detail.
Civil Service Rule XIII§1.5.F
When discrimination is alleged to be a basis for appeal, specific facts supporting the allegation of discrimination must be provided in detail by the appealing party. The specific facts required will vary, depending on the nature of the appeal; however, the facts must be presented in sufficient detail to enable the Appointing Authority to prepare a defense. A supposition [assumption] of discrimination is not sufficient. The types of facts which must be included are:
- the date, time, and place the discriminatory action took place;
- the name(s) of person(s) or department(s) alleged to have taken the discriminatory action;
- a description of how the appellant’s action, conduct, or performance was the same as that of other persons who were treated differently;
- the names of other persons treated differently, if known, and the dates the different treatment occurred; and
- a description of events, including the dates and circumstances thereof, which led appellant to believe that the adverse decision was based on his religious or political beliefs, gender, sexual orientation, race, or other non-merit factor.
Persons alleging discrimination as a basis for appeal shall bear the burden of proof of their allegations.
[___]Check this box if you allege discrimination. Give full details in the space provided below, giving specific facts as required under Civil Service Rule XIII§1.5.F which support your allegation of discrimination. (If necessary, attach additional sheets.)
______
______
I am aware that I may be opposed by an attorney and that I have the right, but am not required, to employ an attorney to represent me. The name of my attorney is: (if none, write NONE in the space provided for the attorney’s name).
Name of Attorney: ______
Mailing Address: ______
Street Number Post Office Number
______
City State Zip Code
Phone Number: (___)______(____)______
Office Number Facsimile Number
Attorneys, please attach a letter of enrollment with your address, phone and fax numbers.
______
Signature of Employee or AttorneyDate
WITNESS LISTS / REQUEST
(Provide to Director seven (7) calendar days in advance of the date of the hearing)
Employee’s Name:______
Docket No:______Department: ______
Subpoenas requested on behalf of:employee[___]administration[___]
Witnesses Employed by the City of Alexandria
Name of WitnessDepartment What facts are to be proved by this witness?
Witnesses Not Employed by the City of Alexandria
Name of Witness Mailing Address What facts are to be proved by this witness?
DOCUMENTS / EVIDENCE FOR THE HEARING
(Provide to Director seven (7) calendar days in advance of the date of the hearing)
Employee’s Name:______
Docket No:______Department: ______
At least seven (7) calendar days in advance of the date of the hearing the employee or his/her attorney and the Appointing Authority shall provide the Commission, through the Director of Civil Service, with copies of all documents and evidence that will be introduced at the hearing. No party shall place into evidence at the hearing any documents that have not been submitted to the Commission in accordance with the provisions of Civil Service Rule XIII§2.3.C, except upon approval of the Commission and for good cause shown. This provision does not apply to documents or statements to be used for impeachment purposes. For each document listed, identify the custodian of the document and explain what facts are to be proved by the document. If the custodian is not a listed witness, identify which department or agency employs the document’s custodian or provide the custodian’s mailing address. Attach additional sheets, if necessary.
Document 1: ______
Custodian of Document:______
Location of Document: ______
Facts to Be Proved by Document: ______
Document 2: ______
Custodian of Document:______
Location of Document: ______
Facts to Be Proved by Document: ______
Document 3: ______
Custodian of Document:______
Location of Document: ______
Facts to Be Proved by Document: ______
Document 4: ______
Custodian of Document:______
Location of Document: ______
Facts to Be Proved by Document: ______
Total Number of Pages Attached, Not Including the Petition to Appeal: ______
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