UnitV_NLBRform5012.pdf

PRIVACY ACT STATEMENT

6. DECLARATION
I declare that I have read the above charge and that the statements are true to the best of my knowledge and belief.

k. The above-named employer has engaged in and is engaging in unfair labor practices within the meaning of section 8(a), subsections (1) and (list

subsections) g

g. e-Mail

4d. Fax No.

FORM EXEMPT UNDER 44 U.S.C 3512

UNITED STATES OF AMERICA
NATIONAL LABOR RELATIONS BOARD
CHARGE AGAINST EMPLOYER

INTERNET
FORM NLRB-501

(2-08)

INSTRUCTIONS:
File an original with NLRB Regional Director for the region in which the alleged unfair labor practice occurred or is occurring.

Address

4a. Address (Street and number, city, state, and ZIP code)

d. Address (Street, city, state, and ZIP code)

1. EMPLOYER AGAINST WHOM CHARGE IS BROUGHT

e. Employer Representative

DO NOT WRITE IN THIS SPACE

of the National Labor Relations Act, and these unfair labor

Case Date Filed

a. Name of Employer b. Tel. No.

i. Type of Establishment j. Identify principal product or service

2. Basis of the Charge

4b. Tel. No.

f. Fax No.

3. Full name of party filing charge (if labor organization, give full name, including local name and number)

practices are practices affecting commerce within the meaning of the Act, or these unfair labor practices are unfair practices affecting commerce
within the meaning of the Act and the Postal Reorganization Act.

(set forth a clear and concise statement of the facts constituting the alleged unfair labor practices)

5. Full name of national or international labor organization of which it is an affiliate or constituent unit (to be filled in when charge is filed by a labor
organization)

(factory, mine, wholesaler, etc.)

Solicitation of the information on this form is authorized by the National Labor Relations Act (NLRA), 29 U.S.C. § 151 et seq. The principal use of the information is to assist
the National Labor Relations Board (NLRB) in processing unfair labor practice and related proceedings or litigation. The routine uses for the information are fully set forth in
the Federal Register, 71 Fed. Reg. 74942-43 (Dec. 13, 2006). The NLRB will further explain these uses upon request. Disclosure of this information to the NLRB is
voluntary; however, failure to supply the information will cause the NLRB to decline to invoke its processes.

WILLFUL FALSE STATEMENTS ON THIS CHARGE CAN BE PUNISHED BY FINE AND IMPRISONMENT (U.S. CODE, TITLE 18, SECTION 1001)

c. Cell No.

h. Number of workers employed

4c. Cell No.

4e. e-Mail

Fax No.

Tel. No.

Office, if any, Cell No.

e-Mail

(signature of representative or person making charge)
By

(Print/type name and title or office, if any)

(date)

4689-3 1/21/17

Delphi Golf and Restaurant, Inc.
315-415-0000

315-415-1111

123 Corporate Drive
Any Town, USA

Dewey, Long and Howe, LLC
315-415-2222

[email protected]

90

Golf Course & Resturant Service of food and entertainment

Section 8(b)(l)(A) and (2) and (3) of the NLRA.

On July 29, 2016 Delphi Golf, Inc. and the ABC Union entered into a collective-bargaining agreement. The majority of the
Company’s employees in the collective-bargaining unit covered by the agreement had not designated the ABC Union as
their collective-bargaining representative, the agreement,contains a union-security clause requiring employees who are
members in good standing of the ABC Union to maintain their membership in good standing and all other employees to
become members of the ABC Union on or before the thirty-first day following the effective date of the agreement or the date
of their hire, a job referral procedure, and a provision for check-off of union dues; upon instructions from the ABC Union, the
Company refused to employ the above three waitresses for restaurant positions because the above applicants were not
members of the Union. By conduct set forth in the complaint the Company and the Union infringed upon employee rights
protected by Section 7 of the Act. Jonathan Smith and 3 other employees were suspended for 3 days for their involvement.

Dorthy Pearce,Helen Clark and Mary Ellen Cook–prospective employees for position of waitresses
Johnathan Smith on behalf of non-members of ABC union.

5678 Main Street
Any Town, USA

315-415-6666

315-415-7777

315-415-8888

Jonathan Smith on behalf of the above.

5678 Main Street, Any Town USA
1/20/17

315-415-9999

315-415-3333

315-415-4444

[email protected]