The following is a model form created by the FLRA Office of the General Counsel to assist unions in 

articulating their interests in information requested from agencies under section 7114(b)(4) of the 

Federal Service Labor Management Relations Statute.

Union Request For Information Under Section 7114(b)(4) of the Statute: A Model for Use

When Requesting Information.

DATE: Date of the information request. 

REQUESTER: Name of the requesting union. ____________________________________________ __

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UNION CONTACT: Name, position, mailing address and phone number of the union

contact submitting the request: __________________________________________________________

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AGENCY CONTACT: Name, position, mailing address and/or phone number of the

agency representative to whom the request is being made. ___________________________________

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INFORMATION REQUESTED: Description of information requested. (Include whether

personal identifiers (such as names, social security numbers or other matters identifying

individual employees) are included or may be deleted.) _______________________________________

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PARTICULARIZED NEED: Specific statements explaining exactly why the union needs

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the requested information. (Explain exactly how the union intends to use the requested

information and how that use of the information relates to the union's role as the exclusive

representative. Include a specific statement for each type of information requested, as well as for
the time period(s) encompassed by the request and the need for personal identifiers, if

applicable.) _________________________________________________________________________

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PRIVACY ACT: Do you know if the requested information is contained within a system

of records under the Privacy Act? (If so, identify that system of records.) ______ __________________

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PUBLIC INTEREST: If you know or think that the requested information is within a

system of records under the Privacy Act, describe how disclosure of the requested

information, including any personal identifiers and the time period encompassed by the

request, would shed light on the agency's performance of its statutory duties or otherwise

inform citizens of the activities of the Government. ________________ _______________________ _ 

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OTHER MATTERS: Other matters related to the request for information. (Discuss any

other matters not listed above which relate to the union's information request and which may

assist the agency in responding to the request.) ____________________________________________

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