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Employment Tribunal Claim (ET1)

A completed fictional ET1-style claim recording ACAS early conciliation, facts, jurisdiction and remedy.

Jurisdiction: England and Wales - completed fictional worked example

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Important: This sample provides general legal information only and is not legal advice. Check the law, prescribed forms and signing requirements that apply to your exact jurisdiction and circumstances before use.

# EMPLOYMENT TRIBUNAL CLAIM (ET1)

Date: 3 January 2031

Parties: Helen Ward and Northmoor Analytics Limited

## 1. Purpose and parties

Claimant Helen Ward was employed by Northmoor Analytics Limited as a Senior Data Engineer from 2 March 2026 until dismissal on 18 October 2030. She presents this fictional ET1-style particulars after ACAS Early Conciliation certificate number R123456/30/81, issued 20 December 2030.

## 2. Facts, scope and terms

The claims are ordinary unfair dismissal and disability discrimination under the Equality Act 2010. Helen relies on chronic migraine, known to HR, and says the company failed to consider a requested reduced-screen adjustment before selecting her for redundancy and dismissing her.

## 3. Process and responsibilities

Helen raised a written grievance on 25 September 2030 and appealed the outcome on 8 November. The redundancy meeting on 10 October gave 48 hours to respond to a scoring sheet that contained a disputed absence score. The dismissal letter gave a right of appeal but did not explain why the adjustment was rejected.

## 4. Evidence, records and safeguards

The Tribunal has jurisdiction because the respondent is an employer, Helen was an employee and the acts occurred in England. ACAS early conciliation was completed; the claimant asks the Tribunal to assess limitation by reference to the relevant act and certificate. This document is not a substitute for the prescribed online ET1.

## 5. Review, escalation and outcome

Helen seeks a declaration, compensation for financial loss and injury to feelings where legally available, interest, and any appropriate recommendation or remedy. She will provide the contract, occupational-health report, adjustment request, scoring documents, grievance, appeal, dismissal letter and mitigation evidence.

## 6. Reservations and practical protections

Helen has started work-search, preserves documents and will cooperate with case management, disclosure, witness statements and a remedy schedule. She reserves the right to amend with permission and does not exaggerate facts. Northmoor may defend, dispute causation and rely on a fair reason and process.

## 7. England and Wales law and completion

England and Wales law and Employment Tribunal procedure apply. The claim is dated 3 January 2031 and filed electronically through the Tribunal service; Helen signs the statement of truth and will notify the Tribunal of any address change.

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