POSH operational template
Interim relief request
A controlled starting format for adaptation to the establishment, applicable rules and matter facts.
Use with care: Do not treat this template as legal advice or as a substitute for the Act, Rules, State requirements, service rules or procedural fairness.
CONFIDENTIAL REQUEST UNDER SECTION 12
I request the Committee to consider the following interim measure(s): [transfer / leave / reporting-line change / academic-supervision restriction / other prescribed relief].
Risk or hardship addressed:
Urgency:
Suggested duration:
Effect on work/education and proposed safeguards:
Supporting material:
This request is made without prejudice to the merits of the complaint.
Name / signature / date: