Joint Request For Certification {PERA-1} | Pdf Fpdf Doc Docx | Pennsylvania

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Joint Request For Certification {PERA-1} | Pdf Fpdf Doc Docx | Pennsylvania

Joint Request For Certification {PERA-1}

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

Alternate TextLast updated: 8/12/2008

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PERA-1 REV 9-96 COMMONWEALTH OF PENNSYLVANIA Pennsylvania Labor Relations Board ------------------------------JOINT REQUEST FOR CERTIFICATION ------------------------------IN THE MATTER OF THE EMPLOYES OF DO NOT WRITE IN THIS SPACE Case No. Date Filed 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 and affiliation, if any) 2. That the public employer is (state name, address, zip code, telephone number) 3. That the employer has agreed to recognize pursuant to Section 602(a) of the Public Employe determination that a majority of the employes in to be represented by the employe representative, based upon the employe representative Relations Act based on a the proposed unit desire which determination is (state method used to determine the desire of the majority of employes) 4. Description of the unit deemed to be appropriate: INCLUDED: EXCLUDED: 5. Approximate number of employes in the unit claimed to be appropriate: (OVER) American LegalNet, Inc. www.FormsWorkflow.com 6. The proposed unit includes: [CHECK APPROPRIATE BOX(ES)] NONPROFESSIONAL EMPLOYES ONLY 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) 7. That there are no other employe representatives claiming to represent any of the employes in the proposed bargaining units except (state name, address, zip code, telephone number or write NONE) 8. That the public employer has posted the five (5) day Notice pursuant to 34 Pa. Code § 95.11(8). ATTACH APPROPRIATE PROOF OF POSTING. 9. Other relevant facts: WHEREFORE, Petitioners respectfully pray that the Pennsylvania Labor Relations Board pursuant to Section 602(a) of the Public Employe Relations Act approve the proposed unit as appropriate and certify the employe representative as the exclusive representative for all employes in the unit. Petitioner-Employe Representative By Title Telephone Number By Title Petitioner-Public Employer Telephone Number INCOMPLETE OR INACCURATE STATEMENTS MAY RESULT IN A DISMISSAL OF THIS PETITION American LegalNet, Inc. www.FormsWorkflow.com

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