TEAMSTERS LOCAL NO. 63
Authorization for Representation Form
 Authorization for Representation Form:
to print select File -> Print then click

Authorization for Representation
I, the undersigned employee of

COMPANY __________________________________________________________________

ADDRESS ___________________________________________________________________
authorize Teamsters local 63 to represent me in negotiations for
better wages, hours, benefits and working conditions.


NAME _______________________________________________________________________

ADDRESS ___________________________________________________________________

CITY/STATE _________________________________________________________________

HOME PHONE ( ________ ) _________________________________

PRESENT WAGE RATE:____________________________________________________

KIND OF WORK: _________________________________________________________

SHIFT: _________

day _________ swing _________ graveyard _________
SIGNATURE: _________________________________


This information is strictly confidential
All information is kept confidential by the Teamsters Union and the
U.S. Government. All information shall be kept in absolute confidence
by the Union and the National Labor Relations Board.
The National Labor Relations Act of 1947 reads as follows:
"Rights of Employees - Sec 7. Employees shall have the right to self-organization to form, join, or assist labor organizations, to bargain collectively through representation of their own choosing, and to engage in other consorted activities for the purpose of collective bargaining or other mutual aid or protection..."

"UNFAIR LABOR PRACTICES - Sec.8(a) It shall be an unfair labor practice for an employer —
"(1) to interfere with, restrain, or coerce employees in the exercise of the rights guaranteed in Section 7;"
"(2) to dominate or interfere with the formation or administration of any labor organization..."

THE FEDERAL LAW UPHOLDS YOUR RIGHT TO ORGANIZE - PLEASE SIGN NOW!
Print out and mail or fax to: 845 Oak Park Road., Covina, CA 91724 (626) 859-4084 Fax or 379 W. Valley Blvd. Rialto, CA 92376 (909) 877-2452 Fax