Request to elect party status 

[Date]

Executive Secretary
Occupational Safety & Health Review Commission
One Lafayette Centre
1120 20th Street, NW, Room 980
Washington, DC 20036-3419

Re: Secretary of Labor v. [Company]
Inspection No. [ ________ ]
OSHRC Docket No. [ ________ (if known)]

Dear [ _________________ ]:

Please be advised that we wish to elect party status in OSHRC Inspection No. [ _______ (and Docket No., if known)], Secretary of Labor v. [Company Name], on behalf of the affected employees. The International Brotherhood of Teamsters and its Local Union [ ____ ] are the authorized bargaining agents for the employees at this establishment.

We request that copies of all documents filed in the case be forwarded to us as we wish to participate in the settlement conference or a hearing..

Sincerely yours,
[ __________________ ]
[ __________________ ]

cc: International Brotherhood of Teamsters
Safety and Health Department
25 Louisiana Avenue, N.W., Washington, D.C. 20001 

Company Representative


Department of Labor Regional Solicitor's Office

OSHA Area Office