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Notice of Bargaining

By completing the following form you are hereby notifying FMCS that written notice of proposed termination or modification of the existing collective bargaining contract was served upon the other party to this contract and that no agreement was reached.

Case Background
* Notice Filed on Behalf of:	Union Employer
* Type of Notice:	Expiring Contract Initial Contract Grievance
	This is a Health Care industry notice.
Contract Expiration:	Format: MM/DD/YYYY
	This is a Contract Reopener with a Reopen date of:
* Industry:
Number of Bargaining Unit Employees Covered by this Contract:
Total Number of Employees at Affected Location(s):

Case Contacts

* Employer/Agency:
* Contact Name:
Contact Title:
* Mailing Address:

* City:
* State:
* Zip Code:
* Work Number:
Fax Number:
Email:

* Union:	Local #:
* Contact Name:
Contact Title:
* Mailing Address:

* City:
* State:
* Zip Code:
* Work Number:
Fax Number:
Email:

Geography
Location of Affected Establishment
* City: * State: * Zip Code:
Location of Negotiations (if different from Affected)
City: State: Zip Code:




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