"Petition for Decertification Template (Rd) - Removal of Representative"

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1) PETITION SIGNATURES SHOULD
ONLY BE COLLECTED ON NON-
WORK TIME, IN NON-WORK AREAS.
2) THE UNION AND EMPLOYER NAMES
MUST BE FILLED IN BEFORE
SIGNATURES ARE COLLECTED.
3) THE EMPLOYER MAY NOT ASSIST
OR CONTRIBUTE RESOURCES.
IF THESE CONDITIONS ARE NOT MET,
THE PETITION MAY NOT BE VALID.
1) PETITION SIGNATURES SHOULD
ONLY BE COLLECTED ON NON-
WORK TIME, IN NON-WORK AREAS.
2) THE UNION AND EMPLOYER NAMES
MUST BE FILLED IN BEFORE
SIGNATURES ARE COLLECTED.
3) THE EMPLOYER MAY NOT ASSIST
OR CONTRIBUTE RESOURCES.
IF THESE CONDITIONS ARE NOT MET,
THE PETITION MAY NOT BE VALID.
Petition for Decertification (RD)—
Removal of Representative
The undersigned employees of ____________________________________ (employer name) do not want to
be represented by ____________________________________ (union name).
Should the undersigned employees make up 30% or more (and less than 50%) of the bargaining unit
represented by ____________________________________
(union name), the undersigned employees
hereby petition the National Labor Relations Board to hold a decertification election to determine whether
a majority of employees no longer wish to be represented by this union.
Should the undersigned employees make up 50% or more of the bargaining unit represented by
____________________________________ (union name), the undersigned employees hereby request that
____________________________________ (employer name) withdraw recognition from this union immediately,
as it does not enjoy the support of a majority of employees in the bargaining unit.
Signature
Name (Print)
Date
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