LRA 7.11 CCMA Referral Form
Refers a dismissal or unfair labour practice dispute to the CCMA for conciliation.
About this document
Identifies the parties, the nature of the dispute, the date it arose and the outcome sought. Proof of service on the employer must be attached.
Jurisdiction warning
South Africa. Bargaining council disputes may use council-specific forms instead.
What the form asks for
- 1
Employee details
- 2
Employer details
- 3
Nature of dispute
- 4
Date of dismissal
- 5
Outcome sought
- 6
Proof of service
Always file the authority’s own version
This page explains what the form asks for. It is not the form itself, and we deliberately do not host a copy: official forms are revised, renumbered and withdrawn without notice, and a court or agency can reject an out-of-date or unofficial version. Download the current form from the issuing body, and check any filing deadline that applies to your case.