Joint Election Request {PERA-3} | Pdf Fpdf Doc Docx | Pennsylvania

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Joint Election Request {PERA-3} | Pdf Fpdf Doc Docx | Pennsylvania

Joint Election Request {PERA-3}

This is a Pennsylvania form that can be used for Workers Comp.

Alternate TextLast updated: 8/20/2008

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PERA-3 (Rev. 6/82) COMMONWEALTH OF PENNSYLVANIA Pennsylvania Labor Relations Board ---------------------JOINT ELECTION REQUEST ---------------------IN THE MATTER OF THE EMPLOYES OF DO NOT WRITE IN THIS SPACE Case No. Date Filed ABOVE IS FOR PLRB USE ONLY TO THE HONORABLE, THE MEMBERS OF THE PENNSYLVANIA LABOR RELATIONS BOARD: The Petition of the employe representative and the public employer herein respectfully sets forth: 1. That the employe representative is (state name, address, zip code, telephone number) 2. That the public employer is (state name, address, zip code, telephone number) 3. That the employer has received from the employe representative written notification and request for Consent Election containing basis of determination of 30% interest, pursuant to Section 603(a) of the Public Employe Relations Act on copy of which is attached hereto. (date) 4. Description of the Unit deemed to be appropriate: INCLUDED: EXCLUDED: 5. 6. Approximate number of employes in unit claimed to be appropriate: The proposed unit includes: NONPROFESSIONAL EMPLOYES ONLY [CHECK APPROPRIATE BOX(ES)] SECURITY GUARDS ONLY (Refer to Section 604(3) of the Act) PRISON GUARDS ONLY (Refer to Section 604(3) of the Act) FIRST LEVEL SUPERVISORS ONLY (Refer to Section 604(5) of the Act) PROFESSIONAL EMPLOYES ONLY PROFESSIONAL AND NONPROFESSIONAL EMPLOYES (Refer to Section 604(2) of the Act) American LegalNet, Inc. www.FormsWorkflow.com 8. That there are no other employe representatives claiming to represent any of the employes in the proposed bargaining unit except (state name, address, zip code, telephone number, or write NONE) 9. An agreed alphabetized eligibility list of those entitled to vote is attached hereto. (If there is any question, contact the Board). 10. That the parties hereto desire that the election be held on (date and time period) at (specific location for voting) and attached hereto is an agreed list of watchers. 11. That the public employer has posted the five (5) day Notice pursuant to 34 Pa. Code § 95.13(c). (Attach appropriate proof of posting.) WHEREFORE, the Petitioners respectfully pray that the Pennsylvania Labor Relations Board, pursuant to Section 603(b) of the Public Employe Relations Act, order an Election to ascertain the exclusive representative, if any, for the purposes set forth in the Public Employe Relations Act. (Public employer) By Title Telephone Number (Employe representative) By Title Telephone Number (INCOMPLETE OR INACCURATE STATEMENTS HEREON MAY RESULT IN A DISMISSAL OF THIS PETITION) American LegalNet, Inc. www.FormsWorkflow.com

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