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UC Petition Form. This is a Official Federal Forms form and can be use in National Labor Relations Board.
Tags: UC Petition, NLRB-502 (UC), Official Federal Forms National Labor Relations Board,
UNITED STATES OF AMERICA NATIONAL LABOR RELATIONS BOARD INSTRUCTIONS: Unless e-Filed using the Agency's website, , submit an original of this Petition to an NLRB office in the Region in which the employer concerned is located. DO NOT WRITE IN THIS SPACE PURPOSE OF THIS PETITION: UC - UNIT CLARIFICATION - A labor organization is currently recognized by the Employer, but the Petitioner seeks clarification of the placement of certain employees or job classifications. The Petitioner alleges that the following circumstances exist and requests that the National Labor Relations Board proceed under its proper authority pursuant to Section 9 of the National Labor Relations Act. (Street and number, city, state, ZIP code)WILLFUL FALSE STATEMENTS ON THIS PETITION CAN BE PUNISHED BY FINE AND IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001) PRIVACY ACT STATEMENT Solicitation of the information on this form is authorized by the National Labor Relations Act (NLRA), 29 U.S.C. § 151 et seq. The principal use of the information is to assist the National Labor Relations Board (NLRB) in processing representation and related proceedings or litigation. The routine uses for the information are fully set forth in the Federal Register, 71 Fed. Reg. 74942-43 (Dec. 13, 2006). The NLRB will further explain these uses upon request. Disclosure of this information to the NLRB is voluntary; however, failure to supply the information may cause the NLRB to decline to invoke its processes. - Name and Title 3b. Address (If same as 2b - state same) 3f. E-Mail Address 4a. Type of Establishment (Factory, mine, wholesaler, etc.) 4b. Principal product or service 5a. Description of Present Unit 5b. No. of Employees in Present Unit: 11a. Name of Recognized or Certified Bargaining Agent 11b. Address 11f. E-Mail Address 11h. Date of Recognition or Certification 11i. Expiration Date of Current or Most Recent Contract, if any (Month, Day, Year) 12f. E-Mail Address (Street and number, city, state, ZIP code) 14f. E-Mail Address I declare that I have read the above petition and that the statements are true to the best of my knowledge and belief. 14. Representative of the Petitioner who will accept service of all papers for purposes of the representation proceeding. (Street and number, city, state, ZIP code) 13g. E-Mail Address (including local name and number if applicable) 12. Organizations or persons other than Petitioner and those named in item 11, who claim to represent any employees affected by the proposed clarifications. (If none, so state) (if none, so state) 6a. Description of Proposed6b. No. of Employees in Proposed Unit: 12g. Brief Description of Contract Covering those Employees 7. City and State where unit is located 10. Reason Why Petitioner Desires Clarification 11g. Affiliation, if any 9. Job classifications of employees as to whom the issue is raised and number of employees in each classification Unit previously certified in Case Unit not previously certified8. Check One: www.nlrb.gov/