US LAWS, STATUTES & CODES ON-LINE

Revised May 1964.

Notice to Mediation Agencies

To: Federal Mediation and Conciliation Service, Washington, D.C. 20427; and

To: (Appropriate State or Territorial agency.)

Date __________

You are hereby notified that written notice of the proposed termination or modification of the existing collective bargaining contract was served upon the other party to this contract and that no agreement has been reached.

1. (a) Name of employer (if more than one company or an association, submit names and addresses on separate sheet in duplicate). Phone No. ______

Address of establishment affected (Street) (City) (State) (Zip Code).

(If more than one establishment, or plant, list addresses on separate sheet.)

(b) Employer Official to communicate with (name and title).

Address:        Phone No. ____.

________ (Street), ________ (City), ________ (State).

2. (a) International union ________ Local No. ___. AFL-CIO (  ). Independent (  ). Phone No. ___. Address of local union:

________ (Street), ________ (City), ________ (State), ____ (Zip Code).

(b) Union official to communicate with __________. Phone No. ____—.

Address:

________ (Street), ________ (City), ________ (State), ____ (Zip Code).

3. (a) Number of employees covered by the Contract(s) ___.

(b) Total number employed by the Company at this location(s) ___.

4. Type of establishment and principal products, or services ___________ (Factory, mine, wholesaler, over-the-road trucking, etc.).

5. Contract expiration or reopening date ______.

6. Name of official filing this notice __________. Title ________.

Address ____________ Phone No. ____.

Check on whose behalf this notice is filed:

Union ______. Employer ______

Signature ________________

Receipt of this notice does not constitute a request for mediation nor does it commit the agencies to offer their facilities. This particular form of notice is not legally required. Receipt of notice will not be acknowledged in writing by the Federal Mediation and Conciliation Service. (Attach copies of any statement you wish to make to the Mediation Agencies.)

Copies of this Form F–7 are obtainable at the national, regional and field offices of the Service. This form may be duplicated for use by representatives of employers or unions provided it is copied in full without change.