Case No. Date Filed
The petitioner hereby requests that the Division proceed under the authority of M.G.L. c.150E, Section 4 or
M.G.L. c.150A, Section 5(c). File an original plus two(2) copies of this form with the Division.
1. Petitioner (Check one):
Employee Organization seeking clarification or amendment of a recognized or certified bargaining unit.
Employer seeking clarification or amendment of a recognized or certified bargaining unit.
2. Employer 3. Representative to contact 5. Telephone Number
4. Address (street and No., city/town, state, and ZIP code) 6. Fax Number
7. Employee Organization 8. Representative to contact 10. Telephone Number
9. Address (street and No., city/town, state, and ZIP code) 11. Fax Number
12. Describe existing bargaining unit (attach additional sheets if necessary): 12a. No. of employees in
existing unit
Included
12b. The incumbent
Employee Organization was:
Excluded originally
Attach a copy of the most recent certification and/or current recognition clause. Recognized
13. Date on which the incumbent Employee 14. Expiration date of most recent
Organization was first Recognized or Certified collective bargaining agreement Certified
(If Certified, include case No., if known)
Don't Know
15. List the case Nos. of any prior CAS petitions relevant to this bargaining unit.
16. Title of disputed position(s) (attach position description(s), if available) Date position was created
17. Date on which the Employee Organization first learn of the existence of the position(s) 18. No. of employees in
the proposed unit
DLR FORM-007 (page 1)
Revised 11/07
CLARIFICATION OR AMENDMENT
DO NOT WRITE IN THIS SPACE
COMMONWEALTH OF MASSACHUSETTS
PETITION FOR
DIVISION OF LABOR RELATIONS
19. Are any of the positions included in another bargaining unit?
Yes No
If yes, list the name(s) and address(es) of the Employee Organization(s) that represent
the position(s)
Note: You must serve a copy of this petition on all Employee Organizations known to have an interest in any of the petitioned-for positions.
20. Have there been changes to the job duties since the position was created?
Yes No
If yes, explain (including the date on which any changes occurred)
21. Was the position in existence prior to the negotiations for the most recent
collective bargaining agreement? Yes No
If yes, explain what, if any, discussions the parties had concerning the unit placement of the position
22. Explain why the position should/should not be included in the existing bargaining unit
I have read the above petition and swear under the pains and penalties of perjury that the information contained in it is
true and complete to the best of my knowledge and belief.
Name (print) Signature Title (if any)
Address (street and no., city/town, state, and ZIP code) Telephone Number
I hereby certify that I have served a copy of this Petition on the following representative of the opposing party.
Name Address (street and no., city/town, state, and ZIP code)
Method of Service
In hand First Class Mail Other (specify): ___________________
Signature of Person making Certification Telephone Number
The Division does not discriminate on the basis of disability in access to its services. Inquiries, complaints or requests,
including requests for auxiliary aids and information regarding access features should be directed to the LRC FORM-007 (page 2)
ADA Coordinator (617) 626-7132. This document is available in alternative formats. Revised 11/07
Telephone Number
Answer the following questions for each of the positions listed in Question No. 16.
Attach additional sheets if necessary
CERTIFICATE OF SERVICE
DECLARATION