Petition Under The Public Employe Relations Act {PERA-4} | Pdf Fpdf Doc Docx | Pennsylvania

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Petition Under The Public Employe Relations Act {PERA-4} | Pdf Fpdf Doc Docx | Pennsylvania

Petition Under The Public Employe Relations Act {PERA-4}

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

Alternate TextLast updated: 8/20/2008

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PERA-4 REV 3-87 COMMONWEALTH OF PENNSYLVANIA Pennsylvania Labor Relations Board PETITION UNDER THE PUBLIC EMPLOYE RELATIONS ACT IN THE MATTER OF THE EMPLOYES OF: Case No. DO NOT WRITE IN THIS SPACE Date Filed ABOVE IS FOR PLRB USE ONLY 1. Purpose of this Petition: (Check One) - (File Original and Three (3) Copies) PETITION FOR REPRESENTATION - (R) - Thirty percent or more of the emp loyes wish to be represented by Petitioner and Petitioner desires to be certified as representative of the employes. Refer to Section 603(c) of the Public Employe Relations Act (Act) and 34 Pa. Code Sections 95.12 and 95.14. PETITION FOR DECERTIFICATION - (D) - Thirty percent or more of the employes assert that the certified bargaining representative is no longer their representative OR the Employer alleges a good faith doubt of the majority status of the present representative. Refer to Section 607 of the Act and 34 Pa. Code Sections 95.21 and 95.22. PETITION FOR ELECTION BY PUBLIC EMPLOYER - (E) - If either a public employe, group of public employes, or employe organization has presented a claim to the Employer to be recognized as the representative of the employes of the Employer and thereafter does not seek an election. Refer to Section 603(d) of the Act and 34 Pa. Code Section 95.14. PETITION FOR UNIT CLARIFICATION - (UC) - An employe representative is currently recognized by Employer, but Petitioner seeks clarification of the unit previously certified in Case No. ________________________. Refer to 34 Pa. Code Section 95.23. PETITION FOR AMENDMENT OF CERTIFICATION - (U) - Petitioner seeks amendment of certification issued in Case No. ____________________. (ATTACH STATEMENT DESCRIBING THE SPECIFIC AMENDMENT SOUGHT.) Refer to Pa. Code Section 95.23. 2. NAME OF EMPLOYER: ADDRESS: (Street, Number, City, State, ZIP) Representative to contact: Telephone Number: 3. NAME OF EMPLOYE ORGANIZATION: ADDRESS: (Street, Number, City, State, ZIP) Telephone Number: 4. Description of unit deemed to be appropriate: (In UC Petition, describe PRESENT unit and attach description of proposed clarification and reasons for the request.) INCLUDED: EXCLUDED: 5. Approximate number of employes in the unit claimed to be appropriate: PRESENT: PROPOSED BY UC PETITION: 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. Petitioner alleges that 30% or more of the employes in the proposed unit: (Desire to be represented by Petitioner - R Petitions only) OR (No longer desire to be represented by the present employe organization - Employe filed D Petitions only), which allegation is supported by . (Not applicable to Employer D Petition) METHOD USED* *DATED SHOWING OF INTEREST MUST BE ATTACHED HERETO (Refer to 34 Pa. Code Section 95.1) 8. There are no other employe representatives claiming to represent any of the employes in the proposed bargaining unit except (Name, Address, Telephone Number, or write NONE) 9. Date of expiration of current agreement, if any: (Month, Day, Year, or write NONE) 10. The employe organization notified the public employer pursuant to Section 603(c) of the Act on (Date) and requested the public employer to join in a petition for an election. A copy of the notification is attached hereto. (Applicable to R Petitions only) 11. The public employer (refused said request on Petitions only) (Date)) OR (failed to reply). (Applicable to R 12. The public employer agreed on (Date) to join in an election request with the employe representative; however, the employe representative failed to seek an election. (Applicable to E Petitions only) Other relevant facts: 13. I declare that I have read the above petition and that the statements therein are true to the best of my knowledge and belief. (Petitioner and affiliation, if any) BY (Signed and printed name of representative or person filing Petition) (Title, if any) ADDRESS (Street & Number, City, State and ZIP) PHONE NUMBER (INCOMPLETE OR INACCURATE STATEMENTS HEREON MAY RESULT IN A DISMISSAL OF THIS PETITION) American LegalNet, Inc. www.FormsWorkflow.com

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