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Placed on Leave without Pay - Class Action Questionnaire

Particulars of person’s situation and claim as members of the proposed class.

1. Name:

2. Current mailing address:

3. Usual residential address if different to (2) above

4. Your contact information:    
Telephone:
Email:

5. Alternative contact person:
Their name
Their relationship to you
Their email and/or/telephone number:

6. Employment Details:
Employer:      
Position(s) Held:
Was position permanent/ or term:
How long were you employed for at that position?
Annual Salary:
Were you placed on Leave without Pay for non-vaccination status or refusing to disclose your vaccination status?  
Date Leave without Pay commenced:
Have you returned to your previous employment?

7. Were you formally terminated/fired from your employment?
Did you receive a Record of Employment (“ROE”) and what does it state as the reason you no longer work for your employer?
Were you formally terminated/fired from your employment for non-vaccination status or refusing to disclose your vaccination status?
         
8. Did you apply for Employment Insurance (“EI”)?
If you applied for EI what was the result?
If you were given EI how long did it last for and what amount did you receive?
If you were refused EI what was the reason for the refusal provided to you?
If you did not apply for EI please explain why you did not.|

9. Were you a member of a union?
If you were a member of a union what is the name of the union?
Did your union grieve you being placed on leave without pay?
If your union grieved you being placed on leave without pay what was the ultimate result of the grievance?
If your union told you they would not grieve you being placed on leave without pay did they explain/give you a reason why they would not grieve?

10. Have you been offered to return to your previous employment?
If yes, did you return?  If not please explain why you did not.

11. Please provide details of any losses, financial or otherwise, suffered as a direct result of not being released earlier under APR?
e.g. loss of job income (proof of losses must be attainable);
e.g. loss of opportunity
e.g. missing out on special family event

 

CLASS CATEGORIES FOR NON-UNION EMPLOYEES

If you were placed on leave without pay, were refused employment insurance (“EI”) and were not offered to return to your employment before or after October 1, 2022 you are Class A.

If you were placed on leave without pay, were refused employment insurance (“EI”), were offered to return to your employment and did not return to work before or after October 1, 2022 you are Class B.

If you were placed on leave without pay, were refused employment insurance (“EI”), were offered to return to your employment and did return to work before or after October 1, 2022 you are Class C.

If you were placed on leave without pay, were granted EI and were not offered to return to your employment before or after October 1, 2022 you are Class D.

If you were placed on leave without pay, were granted EI were offered to return to your employment and did not return to work before or after October 1, 2022 you are Class E.

If you were placed on leave without pay, were granted EI were offered to return to your employment and did return to work before or after October 1, 2022 you are Class F.

If you were directly told that you were fired from your employment you are Class G.

If you were placed on leave without pay, did not apply for EI and were not offered to return to your employment before or after October 1, 2022 you are you are Class H.

If you were placed on leave without pay, did not apply for EI and were offered to return to your employment and did not return to work before or after October 1, 2022 you are you are Class I.

If you were placed on leave without pay, did not apply for EI and were offered to return to your employment and did return to work before or after October 1, 2022 you are you are Class J.

CLASS CATEGORIES FOR UNION MEMBER EMPLOYEES

If you were a member of a union and the union grieved your placement of leave without pay, you are Class K.  Please also tick which of the Class A through J above best describes your circumstances.

What was the result of your grievance?

If you were a member of a union and the union refused to grieve your placement of leave without pay you are Class L.  Please also tick which of the Class A through J above best describes your circumstances.

What, if any, reason did the union provide as an explanation as to why they did not proceed with a grievance?

Download Questionairre

 

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