Fillable DIVISION OF LABOR Street, Suite 600 633 17 (Colorado DORA)

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DIVISION OF LABOR Street, Suite 600 633 17 (Colorado DORA)

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ULP-CHG.01(12/99)
BEFORE THE DEPARTMENT OF LABOR AND EMPLOYMENT
DIVISION OF LABOR
633 17
th
Street, Suite 600
DENVER, COLORADO 80202-3660
File No.____________
}
}
}
}
}
PLAINTIFF, } UNFAIR LABOR PRACTICE
} CHARGES
}
Vs. }
}
}
}
}
}
}
RESPONDENT. }
Comes now the Plaintiff(s) above named and complains that the Respondent(s) has (have) engaged in
and is (are) engaging in Unfair Labor Practices contrary to the provisions of 8-3-108, C.R.S., and in that
respect allege(s):
1. Names of Plaintiff(s)__________________________________________________________
Address:____________________________________________________________________
2. Interest of Plaintiff(s) in this matter: (set out in detail how and why plaintiff(s) is interested in
this matter. If additional space is needed, attach additional sheets)
3. Name of Respondent(s)
Address:
Street City State Zip
4. The Respondent(s) is (are):
5. The employer is engaged in (type of business):
6. The employer employs persons in Colorado.
7. Section or sections of Colorado Labor Peace Act violated.
ULP-CHG.01(12/99)
COMPLAINT - Page 2
File No.____________
8. Clear and concise statement of facts constituting the Unfair Labor Practice or Practices, giving
time, place and persons involved:
(If additional space is needed, use additional sheet of paper.)
WHEREFORE, Plaintiff(s) pray that this matter be set for hearing and that after such hearing the
Director of the Division of Labor enter his finding and order as provided by law.
Typed or printed name of plaintiff
Signature of Plaintiff
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signature
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ULP-CHG.01(12/99)
COMPLAINT - Page 3
File No.____________
STATE OF COLORADO }
} SS.
COUNTY OF }
AFFIDAVIT OF PLAINTIFF
, being first duly
sworn, says that the statements made in the above Complaint are
true to the best of his/her knowledge, information, and belief.
Signature of Plaintiff or Agent
Subscribed and sworn to before me this day of , A.D. 20 .
My Commission expires:
NOTARY PUBLIC
Typed or printed name of Attorney for Plaintiff(s)
Mailing Address:
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signature
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DIVISION OF LABOR Street, Suite 600 633 17 (Colorado DORA)

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Completed 20 July 2020

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