Application to Stay a Direction Section 146(2) of the Canada Labour Code Part II–Occupational Health and Safety

I-Applicant Information

Name:

Address:

Telephone Number:

Email Address:

Name of Representative or Counsel:

Address:

Telephone Number:

Email Address:

It is your responsibility to advise the Board in writing of any changes to your contact information.

II–Other Parties Information

1) Other party affected by the application (employer, bargaining agent/union or employee), if applicable

Name:

Address:

Telephone Number:

Email Address:

Name of Representative or Counsel:

Address:

Telephone Number:

Email Address:

2) Other party affected by the application (employer, bargaining agent/union or employee), if applicable

Name:

Address:

Telephone Number:

Email Address:

Name of Representative or Counsel:

Address:

Telephone Number:

Email Address:

III–General Information About the Application to Stay

I wish to stay the direction(s) finding that

I have filed an appeal of the direction(s)

a danger exists

a contravention exists

Date of the direction(s):

Please attach a copy of the direction(s) that you wish to stay.

Attached

Not attached

Reason:

Date that you filed the appeal:

File number of the appeal:

IV–Reasons/Grounds for the Application to Stay

The Board can use its discretion to order a stay of a direction. It may do so if you can show that:

The appeal deals with a serious question
You will suffer significant harm if the direction is not stayed
If a stay is granted, measures will be put in place to protect the health and safety of employees, or any person granted access to the workplace

Keeping in mind these criteria, please provide the reasons/grounds for your application to stay the direction(s). Provide supporting documentation, if applicable/available (clearly identify and number any attachments).

If you are a unionized employee, please complete this section. Otherwise, continue to Section V.

Please note that if you are represented by a union, the Board will notify the union of the application.

Are you a unionized employee?

Yes

Name of Union / Bargaining Agent:

V–Oral Hearing

There is no requirement for the Board to hold a hearing even if one is requested. Most matters before the Board are determined on the basis of the documentation on file. Is a hearing necessary?

Yes

If yes, why do you believe that a hearing is necessary?

Where would you want the hearing to take place?

VI–Filing Your Application to Stay

The Board has an e-filing Web Portal (Portal) service, which allows you to file your Portable Document Format (PDF) documents in the Board’s centralized document filing system. You can access the Portal here. You can also file your application by mail. The Board’s contact information can be found on the Board’s website.

If you choose to file your document electronically using the Portal, do not forward a hard copy of the same document to the Board. The electronic version will be considered the original copy.

Signature

Date:

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Application to Stay a Direction Section 146(2) of the Canada Labour Code Part II–Occupational Health and Safety

Important Information

1) Other party affected by the application (employer, bargaining agent/union or employee), if applicable

2) Other party affected by the application (employer, bargaining agent/union or employee), if applicable

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Application to Stay a Direction Section 146(2) of the Canada Labour Code Part II–Occupational Health and Safety

Important Information

I-Applicant Information

II–Other Parties Information

1) Other party affected by the application (employer, bargaining agent/union or employee), if applicable

2) Other party affected by the application (employer, bargaining agent/union or employee), if applicable

III–General Information About the Application to Stay

IV–Reasons/Grounds for the Application to Stay

If you are a unionized employee, please complete this section. Otherwise, continue to Section V.

V–Oral Hearing

VI–Filing Your Application to Stay

Signature and Date