Form PERA-47 "Fact-Finding Invoice" - Pennsylvania

What Is Form PERA-47?

This is a legal form that was released by the Pennsylvania Department of Environmental Protection - a government authority operating within Pennsylvania. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2018;
  • The latest edition provided by the Pennsylvania Department of Environmental Protection;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form PERA-47 by clicking the link below or browse more documents and templates provided by the Pennsylvania Department of Environmental Protection.

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Download Form PERA-47 "Fact-Finding Invoice" - Pennsylvania

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FACT-FINDING INVOICE
VENDOR INFORMATION
LOCATION CODE: 12PLRB
Name
Vendor ID
Address
Invoice Number
City
State
Zip
Telephone
Signature
Date
CASE INFORMATION
Case Number
Employer
Employe Organization
SERVICES PROVIDED
Hearing date(s):
Number of days: __________
$
Preparation, research, writing date(s):
Number of days: __________
$
EXPENSES
0.00
Mileage: __________miles @ $__________/mile
$
Parking and tolls
$
Lodging
$
Subsistence
$
Postage/Mailing
$
Miscellaneous (please explain):
$
0.00
TOTAL: $ ______________
PLEASE SEND YOUR INVOICE TO THIS ADDRESS:
Pennsylvania Labor Relations Board
AMOUNT BILLED TO COMMONWEALTH
12PLRB
OF PENNSYLVANIA (50% OF TOTAL):
PO Box 69181
0.00
Harrisburg, PA 17106
$ ______________
Third Party Responsibility – NOT billed to Commonwealth of Pennsylvania
0.00
*
__________
*MAIL PAYMENT
Amount Billed to Public Employer (25% of total) $
DIRECTLY TO FACT-FINDER
0.00
*
__________
Amount Billed to Employe Organization (25% of total) $
Pennsylvania Labor Relations Board
651 Boas Street, Room 418 | Harrisburg, PA 17121-0750 | 717.787.1091 |
717.783.2974 | www.dli.pa.gov
F
Auxiliary aids and services are available upon request to individuals with disabilities.
Equal Opportunity Employer/Program
PERA-47 REV 06-18
FACT-FINDING INVOICE
VENDOR INFORMATION
LOCATION CODE: 12PLRB
Name
Vendor ID
Address
Invoice Number
City
State
Zip
Telephone
Signature
Date
CASE INFORMATION
Case Number
Employer
Employe Organization
SERVICES PROVIDED
Hearing date(s):
Number of days: __________
$
Preparation, research, writing date(s):
Number of days: __________
$
EXPENSES
0.00
Mileage: __________miles @ $__________/mile
$
Parking and tolls
$
Lodging
$
Subsistence
$
Postage/Mailing
$
Miscellaneous (please explain):
$
0.00
TOTAL: $ ______________
PLEASE SEND YOUR INVOICE TO THIS ADDRESS:
Pennsylvania Labor Relations Board
AMOUNT BILLED TO COMMONWEALTH
12PLRB
OF PENNSYLVANIA (50% OF TOTAL):
PO Box 69181
0.00
Harrisburg, PA 17106
$ ______________
Third Party Responsibility – NOT billed to Commonwealth of Pennsylvania
0.00
*
__________
*MAIL PAYMENT
Amount Billed to Public Employer (25% of total) $
DIRECTLY TO FACT-FINDER
0.00
*
__________
Amount Billed to Employe Organization (25% of total) $
Pennsylvania Labor Relations Board
651 Boas Street, Room 418 | Harrisburg, PA 17121-0750 | 717.787.1091 |
717.783.2974 | www.dli.pa.gov
F
Auxiliary aids and services are available upon request to individuals with disabilities.
Equal Opportunity Employer/Program
PERA-47 REV 06-18