Parliamentary Employment and Staff Relations Regulations (SOR/86-1140)

[Repealed, SOR/2014-252, s. 31]

Before the Federal Public Sector Labour Relations and Employment Board

• NOTICE: Information relating to the proceedings is subject to the Board’s Policy on Openness and Privacy. In accordance with that policy, the Board conducts its hearings in public, except in exceptional circumstances. It also provides public access to case files and posts its decisions electronically on its website. The Board’s Policy on Openness and Privacy is posted on the Board’s website.

(if necessary, attach additional pages of same size of paper)

• 1 

  Complainant, name and address:

  Respondent, name and address:

• 2 

  The complainant complains that

  • Footnote ^*(a) the employer,

  • Footnote ^*(b) a person acting on behalf of the employer,

  • Footnote ^*(c) an employee organization,

  • Footnote ^*(d) a person acting on behalf of an employee organization,

  • Return to footnote ^*Strike out items not applicable.

  has failed to: (state nature of failure complained of, specifying relevant section of the Act, provision of arbitral award, decision of adjudicator or regulation respecting grievances)

• 3 

  The complainant requests that the Board issue the following order: (state relief sought under subsection 13(2) of the Act)
• 4 

  The following is a concise statement of each act or omission complained of: (Give dates and names of persons involved)
• 5 

  The following steps have been taken by or on behalf of the complainant for the adjustment of the matters giving rise to the complaint:
• 6 

  Other matters considered relevant:

Dated at , this day of , 20

(signature of complainant)

• NOTE: Failure to complete this form by setting out all the particulars may cause delay in the processing of this complaint.

Before the Federal Public Sector Labour Relations and Employment Board

(if necessary, attach additional pages of same size of paper)

• 1 

  Applicant, name and address:

  Employer, name and address:

• 2 

  If the applicant is a council of employee organizations, state the name and address of each constituent employee organization:
• 3 

  Detailed description of the unit of employees of the employer that the applicant proposes as appropriate for collective bargaining:
• 4 

  The grounds on which the applicant intends to rely in support of its proposal that the bargaining unit described in section 3 is appropriate:
• 5 

  Estimated number of employees in the proposed bargaining unit:
• 6 

  The name and address of any employee organization that has been certified as bargaining agent for any of the employees in the unit proposed in section 3:
• 7 

  Other matters considered relevant in support of this application:

Dated at , this day of , 20 and signed on behalf of the applicant by,

(signature)

(office held in employee organization)

• NOTE: Your attention is drawn to section 36 of the Parliamentary Employment and Staff Relations Regulations. Subsection 36(1) provides that an application for certification shall be accompanied by the documentary evidence on which the applicant intends to rely in whole or in part to satisfy the Board that a majority of employees in the proposed bargaining unit wish the applicant to represent them as their bargaining agent. Subsection 36(2) provides that any documentary evidence that does not accompany the application shall be filed on or before the terminal date.

Declaration

I declare that the answers and information contained in this application are true in substance and in fact. I further declare that I have been duly authorized to make this application. I make this solemn declaration conscientiously believing it to be true, and knowing that it is of the same force and effect as if made under oath, and by virtue of the Canada Evidence Act.

Declared by

before me at , in the County of , in the Province of , this day of , 20

(signature)

Commissioner or other authorized person

(to be declared before a Commissioner for taking affidavits or any other person authorized by law to administer an oath)

[Repealed, SOR/2014-252, s. 32]

Before the Federal Public Sector Labour Relations and Employment Board

(if necessary, attach additional pages of same size of paper)

• 1 

  Applicant, name:

  Employer, name and address:

• 2 

  Indicate the total number of persons in the proposed bargaining unit as described in the application:
• 3 

  If you propose a bargaining unit different from the one proposed by the applicant,

  • (a) provide a detailed description of the unit of employees that you propose as appropriate for collective bargaining;

  • (b) provide the grounds on which you intend to rely to show that the bargaining unit described in the application is not appropriate or that the bargaining unit proposed in paragraph (a) is more appropriate than the one proposed by the applicant; and

  • (c) indicate the total number of persons in the bargaining unit proposed in paragraph (a).

• 4 

  If a proposed bargaining unit described by the applicant or by the employer under paragraph 3(a) consists in whole or in part of employees for whom no employee organization is certified as the bargaining agent, indicate which, if any, of those employees you claim should be excluded from the proposed bargaining unit because you consider them to be persons employed in a managerial or confidential capacity.
• 5 

  Other matters considered relevant:

Dated at , this day of , 20, and signed on behalf of the employer by

(signature)

Before the Federal Public Sector Labour Relations and Employment Board

(if necessary, attach additional pages of same size of paper))

• 1 

  Applicant, name:

  Employer, name:

  Intervener, name and address:

• 2 

  The intervener claims to represent (insert number) employees in the bargaining unit described in the application.
• 3 

  The intervener intends to make the following submission at any hearing that may be directed to be held by the Board in the proceeding:

Dated at , this day of , 20, and signed on behalf of the intervener by

(signature)

(office held in employee organization)

• NOTE: The intervener’s attention is directed to subsection 27(1) of the Parliamentary Employment and Staff Relations Regulations, which states:

  “An employee organization intending to apply for certification as the bargaining agent of any employees who may be affected by an application shall file with the Board in triplicate, not later than the terminal date fixed for the application pursuant to paragraph 20(b), an intervener’s application in Form 8.”

Before the Federal Public Sector Labour Relations and Employment Board

(if necessary, attach additional pages of same size of paper)

• 1 

  Applicant, name:

  Employer, name:

  Intervener, name and address:

• 2 

  If the intervener is a council of employee organizations, state the name and address of each constituent employee organization:
• 3 

  (a) Detailed description of the unit of employees of the employer that the intervener proposes as appropriate for collective bargaining:

  • (b) Estimated number of employees within the proposed bargaining unit referred to in paragraph (a):

• 4 

  If you propose a bargaining unit different from the bargaining unit proposed by the applicant, indicate the grounds on which you intend to rely to show that the bargaining unit described in the application of the applicant is not appropriate or that the bargaining unit you propose is more appropriate than the bargaining unit proposed by the applicant:
• 5 

  Other matters considered relevant in support of this application:

Dated at , this day of , 20, and signed on behalf of the intervener by

(signature)

(office held in employee organization)

• NOTE: Your attention is drawn to section 36 of the Parliamentary Employment and Staff Relations Regulations. Subsection 36(1) provides that an application for certification shall be accompanied by the documentary evidence on which the applicant or intervener intends to rely in whole or in part to satisfy the Board that a majority of employees in the proposed bargaining unit wish the applicant or the intervener to represent them as their bargaining agent. Subsection 36(2) provides that any documentary evidence that does not accompany the application shall be filed on or before the terminal date.

Declaration

I declare that the answers and information contained in this application are true in substance and in fact. I further declare that I have been duly authorized to make this application. I make this solemn declaration conscientiously believing it to be true, and knowing that it is of the same force and effect as if made under oath, and by virtue of the Canada Evidence Act.

Declared by

before me at , in the County of , in the Province of , this day of , 20

(signature)

Commissioner or other authorized person

(to be declared before a Commissioner for taking affidavits or any other person authorized by law to administer an oath)

Before the Federal Public Sector Labour Relations and Employment Board

(if necessary, attach additional pages of same size of paper)

• 1 

  Applicant, name and address:

  Bargaining agent, name and address:

• *2 

  Employer, name and address:

  • Return to footnote ^*Strike out if applicant is employer

• 3 

  (a) Description of the unit of employees for which the bargaining agent was certified:

  • (b) Approximate number of employees in the bargaining unit described in paragraph (a):

• 4 

  The section of the Parliamentary Employment and Staff Relations Act under which the applicant claims the certification of the bargaining agent should be revoked:
• 5 

  If the application is made under section 30, 31 or 32 of the Act, a summary of the grounds on which the applicant intends to rely in support of the applicant’s claim that the certification of the bargaining agent should be revoked giving sufficient particulars to enable the bargaining agent to know the case it will be called upon to meet:

Dated at , this day of , 20

(signature)

• NOTE: Your attention is drawn to section 43 of the Parliamentary Employment and Staff Relations Regulations. Subsection 43(1) provides that an application for revocation of certification shall be accompanied by the documentary evidence on which the applicant intends to rely in whole or in part to satisfy the Board that the bargaining agent no longer represents a majority of the employees in the bargaining unit. Subsection 43(2) provides that any documentary evidence that does not accompany an the application shall be filed on or before the terminal date.

Declaration

I declare that the answers and information contained in this application are true in substance and in fact. I make this solemn declaration conscientiously believing it to be true, and knowing that it is of the same force and effect as if made under oath, and by virtue of the Canada Evidence Act.

Declared by before me at , in the County of , in the Province of , this day of , 20

(signature)

Commissioner or other authorized person

(to be declared before a Commissioner for taking affidavits or any other person authorized by law to administer an oath)

[Repealed, SOR/2014-252, s. 33]

Before the Federal Public Sector Labour Relations and Employment Board

(if necessary, attach additional pages of same size of paper)

• 1 

  Applicant, name:
• 2 

  Bargaining agent, name and address:
• 3 

  Employer, name and address:
• 4 

  Estimate the total number of employees in the bargaining unit described in the application:
• 5 

  State the date of certification of the bargaining agent for the bargaining unit described in the application:
• 6 

  Enclose a copy of any collective agreement or arbitral award affecting the employees in the bargaining unit:
• 7 

  Other matters considered relevant:

Dated at , this day of , 20

Footnote ^*(signature for bargaining agent)

Footnote ^*(signature for employer)

• Return to footnote ^*Strike out words that are not applicable

Before the Federal Public Sector Labour Relations and Employment Board

(if necessary, attach additional pages of same size of paper))

• 1 

  Name and address of the party requesting arbitration:
• 2 

  Name and address of the other party to the dispute:
• 3 

  The bargaining unit in respect of which the request is made:
• 4 

  The date on which notice to commence bargaining collectively was given under section 37 of the Act:
• 5 

  Describe the steps that have been taken, including the dates of meetings that have been held, and the progress that has been made in collective bargaining following the giving of notice to commence bargaining:
• 6 

  Specify the terms and conditions of employment in respect of which arbitration is requested:
• 7 

  State your proposals concerning the award to be made by the Board with respect to the terms and conditions of employment specified in section 6:
• 8 

  Attach a copy of any collective agreement entered into by the parties.

Dated at , this day of , 20

(signature)

• NOTE: Under section 53 of the Parliamentary Employment and Staff Relations Regulations, proposals filed in accordance with section 51 or 52 of those Regulations must be filed in both official languages on or before the date set for the hearing of the request for arbitration.

Before the Federal Public Sector Labour Relations and Employment Board

(if necessary, attach additional pages of same size of paper))

• 1 

  Name of the party requesting arbitration:
• 2 

  Name of the other party to the dispute:
• 3 

  The bargaining unit in respect of which the request is made:
• 4 

  Specify the terms and conditions of employment that are additional to those specified in Form 12 in respect of which arbitration is requested:
• 5 

  State your proposals concerning the award to be made by the Board with respect to the additional terms and conditions of employment specified in section 4:
• 6 

  State your proposals concerning the award to be made by the Board with respect to the terms and conditions of employment specified in section 6 of Form 12:

Dated at , this day of , 20

(signature)

Before the Federal Public Sector Labour Relations and Employment Board

• NOTICE: Information relating to the proceedings is subject to the Board’s Policy on Openness and Privacy. In accordance with that policy, the Board conducts its hearings in public, except in exceptional circumstances. It also provides public access to case files and posts its decisions electronically on its website. The Board’s Policy on Openness and Privacy is posted on the Board’s website.

PART 1(To Be Completed in All Cases)

I, the undersigned, refer a grievance to adjudication under section 63 of the Parliamentary Employment and Staff Relations Act. The particulars are as follows:

• 1 

  LAST OR FAMILY NAME (print in block letters)
  • Mr.
  • Mrs.
  • Miss
  • Ms.
• 2 

  FIRST NAME
• 3 

  HOME ADDRESS (no., street, city, province)
• 4 

  HOME PHONE NO.
• 5 

  EMPLOYER
• 6 

  LOCATION
• 7 

  BRANCH OR DIVISION
• 8 

  SECTION OR UNIT
• 9 

  JOB TITLE
• 10 

  JOB CLASSIFICATION
• 11 

  a) Exact date on which the grievance was presented at the first level of the grievance process:

  • (b) Exact date on which the grievance was presented at the final level of the grievance process:

• 12 

  Exact date on which the employer served on you a reply, if any, at the final level of the grievance process:
• (ATTACH A COPY OF THE ORIGINAL GRIEVANCE)

PART 2(Complete Only if Grievance Does Not Relate to the Interpretation or Application of a Collective Agreement or Arbitral Award)

• Indicate the applicable paragraph of subsection 63(1) of the Parliamentary Employment and Staff Relations Act under which the grievance is being referred to adjudication:
  • 63(1)(b) disciplinary action resulting in suspension or a financial penalty
  • 63(1)(c) termination of employment
  • 63(1)(d) demotion
  • 63(1)(e) denial of appointment
  • 63(1)(f) classification

  • NOTE: You do not require the approval or support of your bargaining agent, if any.

  You may be represented by your bargaining agent or, if you have no bargaining agent, by any employee organization willing to represent you, or by counsel or other person, or you may represent yourself.

• 13 NAME, ADDRESS AND PHONE NUMBER OF YOUR REPRESENTATIVE, IF ANY:

• Dated at , this day of , 20

(signature of aggrieved employee)

PART 3(To Be Completed Only if the Grievance Relates to the Interpretation or Application of a Collective Agreement or Arbitral Award)

• NOTE: A grievance relating to the interpretation or application of a collective agreement or arbitral award may not be referred to adjudication without the approval and representation of your bargaining agent.

• 14 NAME OF BARGAINING AGENT:

Dated at , this day of , 20

(signature of aggrieved employee)

• 15 APPROVAL OF BARGAINING AGENT (TO BE COMPLETED BY AUTHORIZED REPRESENTATIVE OF BARGAINING AGENT)

  • (a) The parties to the collective agreement or arbitral award are:

  • (b) The name of the bargaining unit or group in respect of which the collective agreement or arbitral award was made is:

  • (c) The duration of the collective agreement or arbitral award is from to

  • (d) The aggrieved employee relies on the following clause(s) of the collective agreement or arbitral award:

  • (e) Name and address of adjudicator, if any, named in collective agreement:

ON BEHALF OF THE BARGAINING AGENT, I APPROVE OF THE REFERENCE OF THIS GRIEVANCE TO ADJUDICATION AND STATE THAT THE BARGAINING AGENT IS WILLING TO REPRESENT THE EMPLOYEE IN THE ADJUDICATION PROCEEDINGS

• DATE

(signature of authorized representative of bargaining agent)

(office held by authorized representative of bargaining agent)

PART 4Establishment of a Board of Adjudication

The Act provides that a “board of adjudication” may be established, at the expense of the parties, only if the employee so requests and if the employer has no objection. That is the effect of certain provisions in sections 65, 66 and 69 of the Act.

• NOTE: If you request that a “board of adjudication” be established, please state the name and address of your nominee (provided that the nominee has no direct interest in the grievance and provided also that the nominee is willing to serve) and sign below.

NAME, ADDRESS AND PHONE NUMBER OF YOUR NOMINEE:

Dated at , this day of , 20

(signature of aggrieved employee)

[Repealed, SOR/2014-252, s. 34]

Before the Federal Public Sector Labour Relations and Employment Board

• NOTICE: Information relating to the proceedings is subject to the Board’s Policy on Openness and Privacy. In accordance with that policy, the Board conducts its hearings in public, except in exceptional circumstances. It also provides public access to case files and posts its decisions electronically on its website. The Board’s Policy on Openness and Privacy is posted on the Board’s website.

(if necessary, attach additional pages of same size of paper))

• 1 

  Bargaining agent, name and address:

  Employer, name and address:

• 2 

  The employer and the bargaining agent

  • Footnote ^*(a) have executed the collective agreement

  • Footnote ^*(b) are bound by the arbitral award

  a copy of which is attached to this reference.

  • Return to footnote ^*Strike out words that are not applicable

• 3 

  The Footnote ^*employer Footnote ^*bargaining agent seeks to enforce the following obligation that is alleged to arise out of the Footnote ^*collective agreement: Footnote ^*arbitral award:

  • Return to footnote ^*Strike out words that are not applicable

  

  (state nature of obligation and include a reference to the relevant articles of the collective agreement or arbitral award)

  

• 4 

  It is alleged that there has been a failure to observe or to carry out the stated obligation, the particulars of which are as follows:

  

  (state particulars, including dates of the acts or omissions that are alleged to be contrary to the stated obligation)

Dated at , this day of , 20

(signature)

Before the Federal Public Sector Labour Relations and Employment Board

• NOTICE: Information relating to the proceedings is subject to the Board’s Policy on Openness and Privacy. In accordance with that policy, the Board conducts its hearings in public, except in exceptional circumstances. It also provides public access to case files and posts its decisions electronically on its website. The Board’s Policy on Openness and Privacy is posted on the Board’s website.

(if necessary, attach additional pages of same size of paper)

• 1 

  Applicant, name and address:

  Respondent, name and address:

• 2 

  Describe the nature of the offence alleged or the prohibition alleged not to have been observed:
• 3 

  Indicate the section of the Act alleged to have been contravened:
• 4 

  Provide a summary of the material facts on which the applicant intends to rely to support this application:

Dated at , this day of , 20 and signed on behalf of the applicant by

(signature)

• NOTE: Your attention is drawn to subsection 80(1) of the Parliamentary Employment and Staff Relations Regulations, which provides that an application for consent to institute prosecution shall be accompanied by a statutory declaration or a statement made under oath or affirmation by a person who has personal knowledge of the facts on which the applicant relies to support the application.

[Repealed, SOR/2014-252, s. 34]