Employee / Trade Union Acknowledgment of this Application

We the undersigned do hereby confirm, as required, that we have been consulted about the employers need to submit this application. We are aware of the right to submit in writing reasons for objecting to this exemption application (attached as APPENDIX B to this application).

SIGNED ON BEHALF OF THE EMPLOYEES:

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(Print names clearly)

Signed at: ..................................... on.............. day of ........................................... 20 ............

SIGNED ON BEHALF OF THE EMPLOYEE REPRESENTATIVES:

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(Print names clearly)

Signed at: ..................................... on.............. day of ........................................... 20 ............