Nlrb Form-4702 - Annual Notice For Receipt Of Charges And Petitions

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FORM NLRB-4702
(9-03)
NATIONAL LABOR RELATIONS BOARD
ANNUAL NOTICE FOR RECEIPT OF
CHARGES AND PETITIONS
TO: REGIONAL DIRECTOR
THE UNDERSIGNED HEREBY REQUESTS RECEIPT OF ALL CHARGES AND PETITIONS FOR
ALL MATTERS IN WHICH THE ENTITY NAMED BELOW IS A PARTY AND WHICH COME
BEFORE THE REGIONAL OFFICE DURING THE NEXT 12 MONTH PERIOD.
SINCE THIS ANNUAL NOTICE IS NOT A NOTICE OF APPEARANCE, FORM NLRB-4701, OR ITS
EQUIVALENT, MUST BE FILED WITH THE REGIONAL DIRECTOR IF THE UNDERSIGNED OR
ANY OTHER INDIVIDUAL WISHES TO REPRESENT A PARTY IN A SPECIFIC CASE.
NAME OF PARTY:___________________________________________________________
(REPRESENTATIVE INFORMATION)
NAME OF
REPRESENTATIVE:______________________________________________________________________________________________
MAILING ADDRESS:_____________________________________________________________________________________________
___________________________________________________________________________
E-MAIL
ADDRESS:_______________________________________________________________________________________________________
OFFICE TELEPHONE
NUMBER:_______________________________________________________________________________________________________
CELL PHONE NUMBER:____________
_________________________FAX:__________________________________________
SIGNATURE:_____________________________________________________________________________________________________
(Please sign in ink.)
DATE:________________________________________________

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