Form PLRB-15 "Charge of Unfair Labor Practice(S) Under the Pennsylvania Labor Relations Act and Act 111" - Pennsylvania

What Is Form PLRB-15?

This is a legal form that was released by the Pennsylvania Department of Labor & Industry - 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 May 1, 2009;
  • The latest edition provided by the Pennsylvania Department of Labor & Industry;
  • 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 PLRB-15 by clicking the link below or browse more documents and templates provided by the Pennsylvania Department of Labor & Industry.

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Download Form PLRB-15 "Charge of Unfair Labor Practice(S) Under the Pennsylvania Labor Relations Act and Act 111" - Pennsylvania

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CHARGE OF UNFAIR LABOR PRACTICE(S)
UNDER THE PENNSYLVANIA
LABOR RELATIONS ACT AND ACT 111
DO NOT WRITE IN THIS SPACE
________________________________________________
CASE NO.
COMPLAINANT
v.
DATE FILED
_______________________________________________________
RESPONDENT
TO THE HONORABLE, THE MEMBERS OF THE PENNSYLVANIA LABOR RELATIONS BOARD:
COMPLAINANT INFORMATION
________________________________________________________________________________________________________________________
Employe, Employe Organization or Employer
________________________________________________________________________________________________________________________
Name of Person filing charge on behalf of Complainant
Title
________________________________________________________________________________________________________________________
Address
________________________________________________________________________________________________________________________
City
State
Zip
________________________________________________________________________________________________________________________
Telephone
HEREBY CHARGES THAT
RESPONDENT INFORMATION
________________________________________________________________________________________________________
Employer, Employe Organization or Employe alleged to have committed unfair labor practice(s)
________________________________________________________________________________________________________
Address
________________________________________________________________________________________________________
City
State
Zip
________________________________________________________________________________________________________
Telephone
HAS ENGAGED IN UNFAIR LABOR PRACTICE(S) CONTRARY TO THE PROVISIONS OF THE
PENNSYLVANIA LABOR RELATIONS ACT, SECTION 6 AS FOLLOWS:
Choose one:
Choose all that apply:
subsection (1)
clause (a)
clause (d)
subsection (2)
clause (b)
clause (e)
clause (c)
clause (f)
Check here if more than one respondent and list on separate sheet.
Check here if a grievance relating to this issue has been filed and enclose three (3) copies of the grievance
and one (1) copy of the Collective Bargaining Agreement to assist in review of this charge.
FAILURE TO ENCLOSE THESE DOCUMENTS WILL CAUSE A DELAY IN PROCESSING.
PLRB-15 REV 5-09 (Page 1)
CHARGE OF UNFAIR LABOR PRACTICE(S)
UNDER THE PENNSYLVANIA
LABOR RELATIONS ACT AND ACT 111
DO NOT WRITE IN THIS SPACE
________________________________________________
CASE NO.
COMPLAINANT
v.
DATE FILED
_______________________________________________________
RESPONDENT
TO THE HONORABLE, THE MEMBERS OF THE PENNSYLVANIA LABOR RELATIONS BOARD:
COMPLAINANT INFORMATION
________________________________________________________________________________________________________________________
Employe, Employe Organization or Employer
________________________________________________________________________________________________________________________
Name of Person filing charge on behalf of Complainant
Title
________________________________________________________________________________________________________________________
Address
________________________________________________________________________________________________________________________
City
State
Zip
________________________________________________________________________________________________________________________
Telephone
HEREBY CHARGES THAT
RESPONDENT INFORMATION
________________________________________________________________________________________________________
Employer, Employe Organization or Employe alleged to have committed unfair labor practice(s)
________________________________________________________________________________________________________
Address
________________________________________________________________________________________________________
City
State
Zip
________________________________________________________________________________________________________
Telephone
HAS ENGAGED IN UNFAIR LABOR PRACTICE(S) CONTRARY TO THE PROVISIONS OF THE
PENNSYLVANIA LABOR RELATIONS ACT, SECTION 6 AS FOLLOWS:
Choose one:
Choose all that apply:
subsection (1)
clause (a)
clause (d)
subsection (2)
clause (b)
clause (e)
clause (c)
clause (f)
Check here if more than one respondent and list on separate sheet.
Check here if a grievance relating to this issue has been filed and enclose three (3) copies of the grievance
and one (1) copy of the Collective Bargaining Agreement to assist in review of this charge.
FAILURE TO ENCLOSE THESE DOCUMENTS WILL CAUSE A DELAY IN PROCESSING.
PLRB-15 REV 5-09 (Page 1)
SPECIFICATION OF CHARGES
Set forth all of the events alleged to constitute the unfair labor practice(s). Include specific facts, dates, names, addresses, place of
occurrence, and other relevant facts. If additional space is needed, please continue on additional sheet(s).
WHEREFORE, the Complainant respectfully requests the Pennsylvania Labor Relations Board to enter the charge upon the Docket of
the said Board and to issue and cause to be served upon the Respondent above named a Complaint stating the charge(s) of unfair
labor practice(s).
COMMONWEALTH OF PENNSYLVANIA
:
:
ss
COUNTY OF
:
On this __________ day of____________________, 20_____, before me, a ______________________________, in and for said
County and State, personally appeared ______________________________ who being duly sworn according to law, deposes and
says that he/she is the person filing the foregoing CHARGE OF UNFAIR LABOR PRACTICE(S) and is aware of the contents hereof
and that the matters and facts set forth herein are true and correct to the best of his or her knowledge, information and belief.
SWORN AND SUBSCRIBED TO before me
the day and year first aforesaid.
________________________________________________
________________________________________________
Signature of Notary
Signature of Complainant or Representative
FAILURE TO FILE AN ORIGINAL AND THREE (3) COPIES OF THE CHARGE
AND ALL ACCOMPANYING EXHIBITS MAY DELAY PROCESSING.
Pennsylvania Labor Relations Board | 651 Boas Street, Room 418 | Harrisburg, PA 17121-0750
717.787.1091 | Fax 717.783.2974 | www.dli.state.pa.us
Auxiliary aids and services are available upon request to individuals with disabilities.
Equal Opportunity Employer/Program
PLRB-15 REV 5-09 (Page 2)
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