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Application Form For Creation of Local Chapter

1) This document outlines the process and requirements for chartering a new local/chapter union. 2) It requires information about the applicant union, parent federation/national union, officers, establishment covered, and employees. 3) Documentation must include a charter certificate, officer names/addresses, constitution/bylaws, and payment of registration fees. 4) The regional office will verify information, check documentary requirements, and recommend approval or denial of the application.

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Erica Paramio
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202 views

Application Form For Creation of Local Chapter

1) This document outlines the process and requirements for chartering a new local/chapter union. 2) It requires information about the applicant union, parent federation/national union, officers, establishment covered, and employees. 3) Documentation must include a charter certificate, officer names/addresses, constitution/bylaws, and payment of registration fees. 4) The regional office will verify information, check documentary requirements, and recommend approval or denial of the application.

Uploaded by

Erica Paramio
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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BLR Reg. Form No. 5 LOC-LO, s.

2004 (DO 40-B-03)


(For Chartering Locals/Chapters)

CREATION OF LOCAL/CHAPTER
PART I. INFORMATION ABOUT THE REPORTING Date Accomplished:
ORGANIZATION
To be accomplished by the applicant. Supply all required information. Misrepresentation, false statement or
fraud in this application or in any supporting document is a ground for revocation of the legal personality of the
local/chapter.

Name of Applicant Organization

Name of Federation/National Union Charter Certificate No. and Date of Issuance

Address Place/s of Operation of Union

Name of President (Last) (First) (Middle) Address

Date Organized (Day) (Month) (Year) Date of CBL Ratification (If ratification was done on
successive dates, state dates of ratification.)

Fiscal Period Status of Finances


[ ] Calendar Year [ ] Fiscal year (Pls. specify) [ ] w/ Financial Report [ ] w/o Financial Report
______
Name of Establishment Address Industry Classification Product Line
(Pls. refer to PSC in the
LRD)

No. of Employees
Establishment/Company Bargaining Unit Union Members

Male ______ Female ________ Male _______ Female _______ Male ______ Female _______

Description of the Bargaining Unit (Check all appropriate boxes)

Composition: [ ] Supervisory [ ] Rank and File


Structure: [ ] Employer Unit Occupational Unit
Sectoral Classification: [ ] Industry Services Agriculture
Occupational Classification:
[ ] Technical [ ] Administrative [ ] Faculty
[ ] Professional [ ] Manufacturing [ ] Sales/Marketing
Mode of Payment of Wages:
[ ] Monthly-paid [ ] Daily-paid [ ] Hourly paid [ ] Task/“pakiao” [ ] Commission
I attest to the truth of the foregoing.

__________________________________________
Authorized Representative / Position in the Union
(Signature over printed name)
SUBSCRIBED AND SWORN TO before me at ______________________________, Philippines
this ______ day of __________________ 20___, by __________________________ with Community
Tax Certificate No. ___________________ issued at __________________________ on
_________________.
NOTARY PUBLIC
Doc No.
Page No.
Book No.
Series of 20___
p. 2
PART II. PROCESSING OF REQUIREMENTS Date Received:
(To be accomplished by the processor in the RO)

A. Checklist of Documents/Requirements. All the foregoing supporting requirements shall be certified


under oath by the Secretary or the Treasurer, as the case may be, of the local/chapter and attested by its
President. All documents shall be submitted in two (2) copies: one (1) original and one (1) duplicate.
[ ] Duly accomplished form
[ ] A Charter Certificate issued by the federation or national union indicating the creation or
establishment of the local/chapter
[ ] The names of the local/chapter’s officers, their addresses, and the principal office of the local/chapter
[ ] The local/chapter’s constitution and by-laws, provided that where the local/chapter’s constitution and
by-laws is the same as that of the federation or national union, this fact shall be indicated accordingly.

B. Verification (Processor to verify with the records on file with BLR)


[ ] Verified/checked that the federation or national union is a legitimate registered labor organization

C. Payment of Registration Fee


[ ] Registration Fee paid under O.R. No. ______________ Date ____________
[ ] Registration Fee not paid

D. Recommendation on the Application


[ ] Recommending Approval with Certificate of Registration attached
[ ] Recommending Denial due to failure to comply with documentary requirements
(Pls. specify lacking documents)
1. _______________________________________________________
2. _______________________________________________________
3. ______________________________________________________

By: _________________________________
Processor
Date:

PART III. APPROVAL/DENIAL

A. Entry/Denial

[ ] Entered in the registry of legitimate labor organizations with duly signed Certificate of
Registration of Local/Chapter attached
[ ] Entry denied, with duly signed Notice of Non-Compliance

B. Respectfully endorsed to the Director

[ ] For approval of Registration of Creation of Local/Chapter


[ ] For approval of Notice of Non-Compliance

Approved for release.

______________________________________
Signature over Printed Name of Provincial Head Date:

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