Employers to Be Treated As One Employer

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Form 38

APPLICATION FOR

COMMON EMPLOYER DECLARATION

(SECTION 38)

 PLEASE TYPE OR PRINT CLEARLY. ATTACH EXTRA PAGES IF NECESSARY.

TRADE UNION INFORMATION

Name:
Address: City:
Postal Code: E-mail:
Telephone number: Fax:
Cell:
Representative to be contacted:
Address (if different from above):

EMPLOYERS TO BE TREATED AS ONE EMPLOYER

Name:
Address: City:
Postal Code: E-mail:
Telephone number: Fax:
Cell:
Contact Person:
E-mail:

EMPLOYERS TO BE TREATED AS ONE EMPLOYER

Name:
Address: City:
Postal Code: E-mail:
Telephone number: Fax:
Cell:
Contact Person:
E-mail:

EMPLOYERS TO BE TREATED AS ONE EMPLOYER

Name:
Address: City:
Postal Code: E-mail:
Telephone number: Fax:
Cell:
Contact Person:
E-mail:

ADDRESSES AT WHICH THE EMPLOYERS' RECORDS CAN BE INSPECTED IF DIFFERENT FROM

ABOVE

Address: City:
Postal Code:
Address: City:
Postal Code:
Address: City:
Postal Code:
Address: City:
Postal Code:

GENERAL NATURE OF BUSINESS OF EACH OF THE EMPLOYERS

Employer:
Business:
Employer:
Business:
Employer:
Business:

PROVIDE DETAILS AND ENCLOSE COPIES OF ANY CERTIFICATION(S), COLLECTIVE

AGREEMENT(S), AND/OR LETTERS OF UNDERSTANDING FOR THE EMPLOYERS BELOW

Employer:
Certification Date:
Number of Employees in Bargaining Unit:
Term of Collective Agreement:
Letter of Understanding Date:
Employer:
Certification Date:
Number of Employees in Bargaining Unit:
Term of Collective Agreement:
Letter of Understanding Date:
Employer:
Certification Date:
Number of Employees in Bargaining Unit:
Term of Collective Agreement:
Letter of Understanding Date:
List any Employers not certified or subject to a collective agreement or letter of understanding.
Name:
Address: City:
Postal Code: E-mail:
Telephone number: Fax:
Cell:
No. of employees:
Name:
Address: City:
Postal Code: E-mail:
Telephone number: Fax:
Cell:
No. of employees:
To what extent are the activities or businesses identified carried on under common control or direction? Please furnish details of the relationship among these businesses, with particular regard to ownership (directors, officers) financial control and operational control, both direct and indirect.
NOTE: Please attach corporate records where available.
Do the businesses share common facilities, equipment, etc.? In particular,
(a) Do they work out of the same premises?
(b) Do they share office or operating equipment?
(c) Do they utilize the same support staff?
(d) Do they operate under a single accounting or payroll system?
(e) Is there any interchange of employees from one enterprise to another, and, if so, how frequently does it
occur?

LABOUR RELATIONS PURPOSE

What is the labour relations purpose or objective of the request for the application of Section 38?
Would a Section 38 declaration immediately affect the parties, and, if so, specify in what manner?
Additional information that the applicant trade union thinks will be of assistance to the Board:

HEARING

 Are you requesting a hearing before the Board? yes no
 If yes, please provide reasons for the request, the estimated time required and the proposed location of the hearing.
 If there is any urgency to the matter, please explain.
Signature of Complainant or Agent:
(omit if filing electronically)
Print name:
Position:
Date of signing:
COMPLETE (completed forms and supporting documentation, including certified copies of any relevant documents from the Office of the Registrar of Companies; e.g., Certificates of Incorporation and recent Annual Reports should be enclosed)
AND DELIVER TO:RegistrarCopies must be delivered to affected parties.
Labour Relations BoardHas this been done? yes no
600 - 1066 West Hastings Street
Vancouver, BCV6E 3X1
Tel: 604-660-1300
Fax: 604-660-1892
Email:

LABOUR RELATIONS BOARD FEES

NOTE:

APPLICATION/COMPLAINT MUST INCLUDE FEE OF $100.00

PAYMENT (CHECK ONE)

ENCLOSED

TO BE SENT WITH ORIGINAL COPY AS APPLICATION/COMPLAINT SENT BY FAX

CHARGE TO PRE-APPROVED ACCOUNT

METHOD OF PAYMENT (CHECK ONE)

CHEQUE

DEBIT CARD

CHARGE TO PRE-APPROVED ACCOUNT

CREDIT CARD – Information required as follows;

Name as it appears on credit card:

Phone Number of where the card holder can be reached:

E-Mail Address:

Organization Name (if applicable):

Please bill my VISA MASTERCARD

Fee $

Signature:

Card Number:

Expiry Date - Month: Year:

Please note: The credit card information provided on this form will not be retained. Upon authorization of the payment request all credit card information will be destroyed.

04/2013