South Australian Employment Tribunal
Form A36 – Application for release from agreement
Form A36
Application for release from agreement
Case Number(SAET use only)
About this form
- This is the approved form for lodging an enterprise agreement for approval by SAET in accordance with the South Australian Fair Work Act 1994.
- Submitting an incomplete form (including any relevant supporting documents) may result in delays.
- A copy of this application is to be provided by the applicant to all other parties bound by the agreement (or their representatives).
Person/Organisation Filing Application
Name: ......
Contact: ......
(for corporations/organisations, include a contact person name)
Representative of (if applicable): ......
Address: ......
......
......
Telephone: ...... Facsimile: ......
Email: ......
The Application
Application is made pursuant to Section 85 by the party listed above as follows:
(mark only the relevant category)
To seek that SAET release a party from, or vary the terms of, an Agreement in consequence of industrial action - Section 85(1).
To seek that SAET include, omit or vary a stand down provision within an Agreement - Section 85(2).
Part 1: About the Agreement
(i) Title of Agreement sought to be varied or rescinded
Original File Number: ......
(ii)At what date is/was the term of the Agreement due to expire?
Part 2: Other Parties to the Application
For each of the other parties to the Agreement, please supply their name (organisation), contact person (if any) and other contact details:
Name:......
Contact Person: ......
Phone: ...... Fax: ......
Email: ......
Name:......
Contact Person: ......
Phone: ...... Fax: ......
Email: ......
Name:......
Contact Person: ......
Phone: ...... Fax: ......
Email: ......
Name:......
Contact Person: ......
Phone: ...... Fax: ......
Email: ......
Name:......
Contact Person: ......
Phone: ...... Fax: ......
Email: ......
Part 3: The Circumstances of the Application
(i)Describe the circumstances leading to the application and the grounds to be relied upon:
Part 4: The Substance of the Application
Set out the precise terms of the variation or release as sought:
(attach separate sheet if space is not sufficient)
LODGING YOUR COMPLETED FORM
I declare that all of the facts in this application are true and accurate to the best of my knowledge and belief:
Name of person lodgingSignature
Date
Please lodge this form, together with any accompanying documents, with the South Australian Employment Tribunal:
Email:
Post: PO Box 3636, Rundle Mall, SA, 5000
In person: Level 6, Riverside Centre, North Terrace, Adelaide, 5000
SAET Registry: 08 8207 0999