If you are applying for a new explosive storage permit, there is no doubt that you will come across the requirement to submit your Perc Form 4. Perc Form 4 is a key step in the process of obtaining an explosives permit and it's important to ensure that everything is filled out correctly before submitting. In this blog post, we'll discuss what exactly is required on the form, how to complete it accurately and efficiently, as well as any other information you need to know about filing your Perc Form 4. Let's dive right in!
| Question | Answer |
|---|---|
| Form Name | Perc Form 4 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | RCDATE, CERTIFICATION, FLORIDA, ORExpiration |
Do Not Write In This Box
STATE OF FLORIDA
PUBLIC EMPLOYEES RELATIONS COMMISSION
4050 Esplanade Way
Tallahassee, Florida
(850)
REPRESENTATION - CERTIFICATION PETITION
CASE NUMBER
RC-
DATE FILED
INSTRUCTIONS:
Submit an original and one (1) copy of this petition to the Public Employees Relations Commission along with proof of simultaneous service upon the other parties. If more space is required for any item, attach additional sheets numbering items accordingly.
Petitioner requests the Public Employees Relations Commission to process this petition under its proper authority.
1.NAME OF PETITIONER: Address:
Zip Code
2.PETITIONER REPRESENTATIVE: Title:
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3.PERC REGISTRATION NUMBER OF PETITIONER: OR- Expiration of current registration:
4.NAME OF EMPLOYER: Address:
Zip Code
5.EMPLOYER REPRESENTATIVE: Title:
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PERC Form 4
Page 1 of 2 (Rev. 6/07)
6.DESCRIPTION OF UNIT proposed to be appropriate for the purpose of collective bargaining. (List individually all job classifications proposed for inclusion.)
INCLUDED:
EXCLUDED:
7.APPROXIMATE NUMBER OF EMPLOYEES in the unit claimed to be appropriate:
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Total number of showing of interest statements signed and dated by employees in the proposed unit are: |
9.Is this petition accompanied by a showing of interest consisting of signed and dated statements from 30% or more of the employees in the proposed unit indicating that they desire to be represented for purposes of
collective bargaining by the petitioning employee organization? |
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YES |
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NO |
10.NAME OF CURRENTLY CERTIFIED BARGAINING AGENT for any of the employees in the proposed unit (if none, so state):
NAME OF UNION:
CERTIFICATION NUMBER:
Bargaining Agent (Union Representative):
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11. Is there an existing collective bargaining contract? |
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YES |
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NO |
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IF YES, date of expiration |
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I have read the above petition and all attachments. The statements contained therein are true to the best of my knowledge and belief. A copy of this fully executed form has been mailed or delivered to the other parties listed in items 5 and 10.
12.DATE OF EXECUTION:
Signature of Petitioner Representative
FALSE STATEMENTS MAY RESULT IN FINE AND IMPRISONMENT
PURSUANT TO CHAPTER 837, FLORIDA STATUTES
PERC Form 4
Page 2 of 2 (Rev. 6/07)