You complete and send this form to tell Acas that you:
- have a dispute with your employer
- intend to make a claim to an employment tribunal
The information you give us is confidential.
You are NOT applying to the employment tribunal when you complete and send this form.
Due to the Coronavirus we are unable to send letters at this time. It is very important that you provide us with a telephone number and email address if at all possible when you request conciliation.
You will need your employer's name and address to complete this service. You will usually find these details on your payslip, contract or letter of employment.
You may want to seek legal advice before you start, or consult your representative if you are a member of a trade union.
If you are unsure what to do about your dispute, call us on 0300 123 1100.
If you are unable to use this online service, please call us on 0300 123 1122 or find other ways to contact us.
We may share your name and address, and the name and address of the individual or organisation you are claiming against, with the employment tribunal, but only with your consent. We will not share your information with anyone else. Find out more about how we store, use and protect your personal information.