Last updated: 8/12/2008
Joint Request For Certification {PERA-1}
Start Your Free Trial $ 13.99What you get:
- Instant access to fillable Microsoft Word or PDF forms.
- Minimize the risk of using outdated forms and eliminate rejected fillings.
- Largest forms database in the USA with more than 80,000 federal, state and agency forms.
- Download, edit, auto-fill multiple forms at once in MS Word using our Forms Workflow Ribbon
- Trusted by 1,000s of Attorneys and Legal Professionals
Description
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
Related forms
-
Defendants Answer To Claim Petition Under Pennsylvania Occupational Disease Act
Pennsylvania/Workers Comp/ -
Informal Conference Agreement Form
Pennsylvania/Workers Comp/ -
Notice Of Request For An Informal Conference
Pennsylvania/Workers Comp/ -
Petition For Joinder Of Additional Defendant
Pennsylvania/Workers Comp/ -
Petition For Physical Examination Or Expert Interview Of Employee (Section 314)
Pennsylvania/Workers Comp/ -
Notice Medical Treatment For Work Injury Or Occupational Illness
Pennsylvania/Workers Comp/ -
Notice To Claimant
Pennsylvania/Workers Comp/ -
Subpoena
Pennsylvania/Workers Comp/ -
Answer To Petition To
Pennsylvania/Workers Comp/ -
Defendants Answer To Claim Petition Under Pennsylvania Workers Compensation Act
Pennsylvania/Workers Comp/ -
Fatal Claim Petition For Compensation By Dependents Of Deceased Employees
Pennsylvania/Workers Comp/ -
Notice Of AbilityTo Return To Work
Pennsylvania/Workers Comp/ -
Petition For Review Of Utilization Review Determination
Pennsylvania/Workers Comp/ -
Physicians Affidavit Of Recovery
Pennsylvania/Workers Comp/ -
Claim Petition For Benefits From Uninsured Employer Guaranty Fund And Uninsured Employer
Pennsylvania/Workers Comp/ -
Charge Of Unfair Labor Practices
Pennsylvania/Workers Comp/ -
Charge of Unfair Practices
Pennsylvania/Workers Comp/ -
Joint Election Request
Pennsylvania/Workers Comp/ -
Joint Request For Certification
Pennsylvania/Workers Comp/ -
Request For Appointment Of Fact-Finding Panel
Pennsylvania/Workers Comp/ -
Petition Under The Public Employe Relations Act
Pennsylvania/Workers Comp/ -
Claimants Statement
Pennsylvania/Workers Comp/ -
Death Claim Supplement To Compromise And Release Agreement
Pennsylvania/Workers Comp/ -
Electronic Data Interchange First Report Of Injury
Pennsylvania/Workers Comp/ -
Defendants Answer To Occupational Disease Claim Petition Section 301(i) Only
Pennsylvania/Workers Comp/ -
Electronic Data Interchange Subsequent Report Of Injury
Pennsylvania/Workers Comp/ -
Group Self-Insurance Fund Member Annual Contribution Worksheet Form
Pennsylvania/Workers Comp/ -
Supplemental Information Addendum To Annual Report Of Runoff Group Self-Insurance Fund
Pennsylvania/Workers Comp/ -
Supplemental Information Addendum To Application As A Group Workers Compensation Fund
Pennsylvania/Workers Comp/ -
Supplemental Information Addendum To Group Sel-Insurance Fund Annual Report
Pennsylvania/Workers Comp/ -
Answer To Petition For Commutation
Pennsylvania/Workers Comp/ -
Petition For Commutation
Pennsylvania/Workers Comp/ -
Child Support Lien Affidavit
Pennsylvania/Workers Comp/ -
Conciliation Invoice
Pennsylvania/Workers Comp/ -
Fact Finding Invoice
Pennsylvania/Workers Comp/ -
Act 88 Arbitration Invoice
Pennsylvania/Workers Comp/ -
Act 195 Interest Arbitration Invoice
Pennsylvania/Workers Comp/ -
Authorization To Release Information-Verification Or Information
Pennsylvania/Workers Comp/ -
Petition (Police, Fire And Private Sector)
Pennsylvania/Workers Comp/ -
Impairment Rating Determination Sheet
Pennsylvania/Workers Comp/ -
Petition To
Pennsylvania/Workers Comp/ -
Request For Panel Of Neutral Interest Arbitrators
Pennsylvania/Workers Comp/ -
Claim Petition For Workers Compensation
Pennsylvania/Workers Comp/ -
Notice Of Claim Against Uninsured Employer
Pennsylvania/Workers Comp/ -
Request For Hearing To Contest Fee Review Determination
Pennsylvania/Workers Comp/ -
Compromise And Release Agreement
Pennsylvania/Workers Comp/ -
Statement Of Wages (For Injuries Occurring On Or Before June 23 1996)
Pennsylvania/Workers Comp/ -
Statement Of Wages (For Injuries Occurring On And After June 24 1996)
Pennsylvania/Workers Comp/ -
Final Statement Of Account Of Compensation Paid
Pennsylvania/Workers Comp/ -
Employees Report Of Benefits For Offsets
Pennsylvania/Workers Comp/ -
Commutation Of Compensation
Pennsylvania/Workers Comp/ -
Employee Verification Of Employment Self-Employment Or Change In Physical Condition
Pennsylvania/Workers Comp/ -
Notice Of Suspension For Failure To Return Form LIBC-760
Pennsylvania/Workers Comp/ -
Notice Of Reinstatement Of Workers Compensation Benefits
Pennsylvania/Workers Comp/ -
Notice Of Workers Compensation Benefit Offset
Pennsylvania/Workers Comp/ -
Interested Party Update Request
Pennsylvania/Workers Comp/ -
Employers Insurance Information Sheet
Pennsylvania/Workers Comp/ -
Employee Report Of Wages And Physical Condition
Pennsylvania/Workers Comp/ -
Dismemberment Chart (Foot)
Pennsylvania/Workers Comp/ -
Workers Compensation Medical Report Form
Pennsylvania/Workers Comp/ -
Authorization For Alternative Delivery Of Compensation Payments
Pennsylvania/Workers Comp/ -
Dismemberment Chart (Hand)
Pennsylvania/Workers Comp/ -
Qualifications Of Reviewer
Pennsylvania/5 Workers Comp/ -
Electronic Data Interchange First Report Of Injury
Pennsylvania/5 Workers Comp/ -
Utilization Review Request
Pennsylvania/Workers Comp/ -
Annual Report Of Accident And Illness Prevention Program Status
Pennsylvania/Workers Comp/ -
Initial Report Of Accident And Illness Prevention Program Status
Pennsylvania/Workers Comp/ -
Insurers Annual Report Of Accident And Illness Prevention Services
Pennsylvania/Workers Comp/ -
Insurers Initial Report Of Accident And Illness Prevention Services
Pennsylvania/Workers Comp/ -
Self-Insured Employers Initial Report Of Accident Prevention Program
Pennsylvania/Workers Comp/ -
Utilization Review Determination Face Sheet
Pennsylvania/Workers Comp/ -
Annual Report Of Accident And Illness Prevention Program Status Self Insured
Pennsylvania/Workers Comp/ -
Expense Loss Cost Multiplier Worksheet For Group Sel-Insurance Fund
Pennsylvania/Workers Comp/ -
Expense Loss Cost Multiplier Worksheet For Group Sel-Insurance Fund
Pennsylvania/Workers Comp/ -
Application For Fee Review Pursuant To Section 306 (F.1)
Pennsylvania/Workers Comp/ -
Claim Petition For Additional Compensation From Subsecquent Injury Fund
Pennsylvania/Workers Comp/ -
Notification Of Suspension Or Modification Pursuant To Section 413 (C) And (D)
Pennsylvania/Workers Comp/ -
Application For Benefits Under Section 909
Pennsylvania/Workers Comp/ -
Occupational Disease Claim Petition
Pennsylvania/Workers Comp/ -
Notice Of Change Of Workers Compensation Disability Status
Pennsylvania/5 Workers Comp/ -
Appeal From Judges Finding Of Fact
Pennsylvania/Workers Comp/ -
Section 304.2 Application For Religious Exception Of Specified Employes
Pennsylvania/Workers Comp/ -
Employees Affidavit And Waiver Of Workers Compensation Benefits And Statement Of Religious Sect
Pennsylvania/Workers Comp/ -
Application For Executive Officer Exception
Pennsylvania/Workers Comp/ -
Agreement For Compensation For Disability Or Permanent Injury
Pennsylvania/Workers Comp/ -
Supplemental Agreement For Compensation For Disability Or Permanent Injury
Pennsylvania/Workers Comp/ -
Agreement For Compensation For Death
Pennsylvania/Workers Comp/ -
Supplemental Agreement Form Compensation For Death
Pennsylvania/Workers Comp/ -
Supplemental Information Addendum To Group Workers Compensation Fund
Pennsylvania/Workers Comp/ -
Third Party Settlement Agreement
Pennsylvania/Workers Comp/ -
Agreement To Stop Weekly Workers Compensation Payments (Final Receipt)
Pennsylvania/Workers Comp/ -
Executive Officers Declaration
Pennsylvania/Workers Comp/
Form Preview
Contact Us
Success: Your message was sent.
Thank you!