Legal Notice

AMABEL LABOUR LAW CONSULTANCY

08 White Street
Wolseley

6830

Phone: 084 980 4446
Mobile:067 718 7996
E-Mail: info@amabeltrading.co.za

CCMA Case Intake Form

Personal Details Full Name * ID / Passport Number * Phone Number * WhatsApp Number (optional) Email Address * Residential Address * Town / City * Province * Preferred Language * Preferred Contact Method

Employment Details Employer Name * Employer Contact (Phone / Email) Employer Physical Address Employer Town / City Employer Province Job Title / Position Date Employment Started Date Employment Ended (if applicable) Current Employment Status

Dispute Details Type of Dispute * Date of Dispute / Incident * Brief Description of What Happened * What Outcome Are You Seeking? Has this matter been reported anywhere else? If yes, where and when?

Union & Attachments Are you a member of USWUSA? Are you a member of any other union? Employment Contract (upload) Payslips (upload) Warning Letters (upload) Other Correspondence (upload)

By submitting this form you consent to Amabel Labour Law Consultancy processing your information to assist with your CCMA matter. This form is for information gathering only and does not replace the official CCMA referral forms.