New York > Statewide > Public Employment Relations Board
Petition For Unit Clarification And Or Unit Placement - New York
| Petition For Unit Clarification And Or Unit Placement Form. This is a New York form and can be used in Public Employment Relations Board Statewide . |
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STATE OF NEW YORK PUBLIC EMPLOYMENT RELATIONS BOARD PETITION FOR UNIT CLARIFICATION AND/OR UNIT PLACEMENT INSTRUCTIONS: File an original and four (4) copies of this Petition with the Director of Public Employment Practices and Representation, N.Y.S. Public Employment Relations Board, 80 Wolf Road, Albany, NY 12205-2670. If more space is required for any item, attach additional sheets, numbering according to the petition item. DO NOT WRITE IN THIS SPACE Case No. CPDate Received: The Petitioner alleges that the following circumstances exist and requests that the New York State Public Employment Relations Board proceed under its proper authority. 1. Purpose of this petition. (Check the appropriate line.) Unit Clarification - a position is encompassed within the scope of an existing unit. Unit Placement - a position should be placed into an existing unit pursuant to the criteria set forth in Section 207 of the Act. A. _____ B. _____ 2. Name of employer: ___________________________________________________ Address (No. & street, city, zip code) _______________________________________ _____________________________________________________________________ Telephone number: ( ) ___________________ County: ________________ Name of petitioner, if not the employer: _____________________________________ Address (No. & street, city, zip code): ______________________________________ _____________________________________________________________________ Telephone number: ( ) ___________________ County: ________________ Name of the representative, if any, to whom correspondence is to be directed: _____________________________________________________________________ Address (No. & street, city, zip code) _______________________________________ _____________________________________________________________________ Telephone number: ( ) ____________________ Identify any currently recognized or certified negotiating agent or any other employee organization(s) which may be affected by this petition. Name: _______________________________________________________________ Address:______________________________________________________________ _____________________________________________________________________ Name: _______________________________________________________________ Address:______________________________________________________________ _____________________________________________________________________ 3. 4. 5. American LegalNet, Inc. www.USCourtForms.com 6. (a) Describe the negotiating unit(s) which may be affected by the petition. Include job titles and classifications, and number of employees in such unit(s). (b) Attach a copy of the most recent contract for the negotiating unit(s). 7. Set forth a clear and concise statement of the details of and the reasons for the proposed clarification or placement. Include the job title and classification, job description and number of employees in each position which is the subject of the petition. I declare that I have read the above Petition and that the statements herein are true to the best of my knowledge and belief. ____________________________ Petitioner By: __________________________ Signature of representative filing petition ( ) ______________________ Telephone ____________________________ Title (if any) Dated: ______________________ PERB 576 (7/99) American LegalNet, Inc. www.USCourtForms.com
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