Form LC 10
REPUBLIC OF NAMIBIA
LABOUR ACT, 2007
(Section 64(3)) (Regulation 11(1))
REQUEST FOR RECOGNTION AS EXCLUSIVE BARGAINING AGENT
Instructions:
1. Attach hereto a copy of trade union registration certificate;
2. Send of proof of service of this request upon the employer or employers'
organization to the Labour Commissioner.
1
Full name of Trade Union seeking recognition:
______________________________________________________________________
______________________________________________________________________
2
Physical Address: _________________________________________________
3
Postal Address: ___________________________________________________
4
Phone: _________________________ Fax: _____________________________
5
E-mail: __________________________________________________________
6
Description of Bargaining Unit for which recognition is sought, specifying whether
the unit is company-wide or departmental or covers specified categories of employees:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
7
Number of employees in the Bargaining Unit:
______________________________________________________________________
8
A majority of the employees in the above-described bargaining unit desire to be
represented by the above-mentioned union as their exclusive bargaining representative.
9
The employer must reply to this request within thirty days of receipt thereof in the
form of Form LC 11.
________________________________
Representative of Trade Union (print name and sign)
__________________________
Position
Date: _____________________
To:
(name and address of trade union)
____________________________________
____________________________________
____________________________________
____________________________________
Copy to:
Labour Commissioner
249-582 Richardine Kloppers Street - Khomasdal
Private Bag 13367
WINDHOEK