Complete and use the button at the end to print for mailing. SD EForm 1654 V1 HELP SD DEPARTMENT OF LABOR ANDOF LABOR SOUTH DAKOTA DEPARTMENT REGULATION DIVISION OF LABOR AND MANAGEMENT DIVISION OF LABOR AND MANAGEMENT , Petitioner, vs. , Respondent. HF No. REQUEST FOR FACT FINDING 1. Employee or Employee Organization: Name of contact person: Address: Telephone: Employer: Name of contact person: Address: Telephone: Date Impasse declared: Date Conciliation held: Brief statement of Impasse: 2. 3. 4. 5. By:_____________________________ DOL-LM 8/02 1 1. PRINT FOR MAILING CLEAR FORM American LegalNet, Inc. www.FormsWorkFlow.com