SD EForm - 1650 V1 SD DEPARTMENT OF LABOR AND REGULATION SD DEPARTMENT OF LABOR AND REGULATION DIVISION OF LABOR AND MANAGEMENT DIVISION OF LABOR AND MANAGEMENT Petitioner, and PETITION FOR ELECTION Respondent. , known as Petitioner states as follows: I. Pursuant to ARSD 47:02:02:02, Petitioner requested recognition from the Respondent on ____________________________, 20___. II. The Parties have not been able to resolve their recognition dispute, and Petitioner requests the Division of Labor and Management to conduct an election subsequent to a unit determination, if necessary. III. The proposed unit is defined as follows: , hereinafter IV. The total number of employees in the defined unit is________. V. Petitioner represents at least 30 percent of the members of the proposed unit. American LegalNet, Inc. www.FormsWorkFlow.com VI. The Petitioner does not: (1) assert the right to strike against the state of South Dakota or any subdivision of the state or to assist or participate in a strike and does not impose a duty or obligation to conduct, assist, or participate in a strike in violation of South Dakota law; advocate the overthrow of the constitutional form of government in the United States; (2) (3) discriminate with regard to the terms of conditions of membership because of race, color, creed, or national origin. This section shall not be construed as limiting the right to advocate peaceful and legal changes in existing law. WHEREFORE, Petitioner requests that an election be conducted by the Division of Labor and Management, and if necessary, a unit determination be made prior to the election. Dated this _________ day of _____________________, 20___. ______________________________ Petitioner PARTIES TO BE NOTIFIED: Petitioner: Name Street City Telephone Respondent: Name Street City Telephone DOL-LM-102-04/00 State Zip State Zip American LegalNet, Inc. www.FormsWorkFlow.com