PERC Form 15 at a glance
What it is: Charge Against Employer, a form of the State of Florida Public Employees Relations Commission.
Who signs: Sign in Signature of Charging Party or Charging Party's Representative.
The Charging Party alleges that the public employer or its agents named in NAME OF EMPLOYER have engaged in (an) unfair labor practice(s) and requests the Public Employees Relations Commission to process this charge under its proper authority.
A filled-in PERC Form 15 example: a first charge against a school board
How to fill out PERC Form 15, box by box
Amended Charge, Case No. CA- and INSTRUCTIONS
Check the box if this is an Amended Charge, Case No. CA-. INSTRUCTIONS: Submit this charge to the Public Employees Relations Commission along with proof of simultaneous service upon the other parties. (NOTE: Pursuant to Florida Administrative Code Rule 60CC-5.001(5), the charge must be accompanied by sworn statements(s) setting forth facts of which the affiant has personal knowledge and, where applicable, documentary evidence sufficient to support a prima facie violation of the applicable unfair labor practice provision(s). Such supporting evidence is not to be attached to the charge and is to be furnished only to the Commission.)
1. Name of Charging Party
In box 1, NAME OF CHARGING PARTY, enter the name, Email Address, Phone No. and Facsimile(Fax) No., then the Address and Zip Code.
2. Charging Party Representative
In box 2, CHARGING PARTY REPRESENTATIVE, fill in Title, Email Address, Phone No. and Facsimile(Fax) No., then the Address and Zip Code.
3. Name of Employer
In box 3, NAME OF EMPLOYER, enter the name, then the Address and Zip Code.
4. Employer Representative
In box 4, EMPLOYER REPRESENTATIVE, fill in Title, Email Address, Phone No. and Facsimile(Fax) No., then the Address.
5. Unfair labor practice sections
In 5, the above-named employer or its agents has (have) engaged in (an) unfair labor practice(s) within the meaning of Section 447.501(1)(a) and, in the blank, (list sections), Florida Statutes.
6. Basis of Charge
In 6, BASIS OF CHARGE, specify facts, names, places, dates, etc. If more space is needed, attach additional pages.
Signing the charge
Sign in Signature of Charging Party or Charging Party's Representative.
The statements contained in this charge are true to the best of my knowledge and belief.
A copy of this fully executed form has been simultaneously served on the representative(s) of the other named party (by hand-delivery, e-mail, facsimile, or U.S. Mail).
False statements may result in fine and imprisonment pursuant to Chapter 837, Florida Statutes.
More rules for PERC Form 15
The Public Employees Relations Commission is at 4708 Capital Circle N.W., Suite 300, Tallahassee, Florida 32303.
The Commission utilizes e-service as the primary method of delivery for orders, correspondence, and notices. Parties are responsible for ensuring that their email address on file with the Commission is correct and current.
Sources
[1] PERC Form 15 (Rev. 3/21), Charge Against Employer, Public Employees Relations Commission (the Official source link on this page).