Early Conciliation Form - for individuals intending to bring a claim to an Employment Tribunal

Fields marked with an asterisk (*) must be completed.

Section A: About you and your claim
You need to complete the following fields:

Please read the important information on the Individual Claimants page the page will open in a new tab(opens in a new tab), then tick here to confirm your understanding of it
1. Your name and contact details

If you do not wish to supply a title please select "Other".

If you don’t have a postcode or cannot find your address, please select the button to the right

If you do not wish to supply a contact number please enter "None".

2. Your representative details
Having a representative is optional, you are not required to appoint one to submit a notification.
You only need to fill in this section if you have appointed a person to act on your behalf (a representative). A representative might be a legal rep, a trade union official, a relative, friend, etc.... Please do not give the name of a representative unless they have agreed to act for you. Do not give the name of a person or organisation who is only giving you advice on filling in this form.
If you appoint a representative we will deal directly with them, not with you.

If you know the name of the person representing you, give it here. If you don't know it, leave this section blank.
Give the full name of the representative's organisation (for example, a trade union, a firm of solicitors, the Citizens Advice Bureau, or other organisation).

Please note, we will always contact you before we contact your employer


This field is limited to 100 characters

If the employer name you want to enter is longer than this please enter just the first word of the name in the field above and type the name in full into the box in Section B below.

If you do not wish to supply a contact number please enter "None".

4. Your employment

Tooltip If employment is continuing, leave blank

Section B: How should we get in touch with you?

Maximum number of allowed characters including spaces: 200

This form should be submitted electronically by clicking 'Submit My Request' above. If you are unable to submit a form electronically, a hard copy version of the form is available from ACAS and that form should be posted to EC Notification, ACAS (Phoenix), PO Box 10279, Nottingham, NG2 9PE.