1. No. _________________________

   Petitioner(s),

   )

   vs.

   )

   PETITION TO DETERMINE

   )

   CONTROVERSY

   Respondent(s).

   )

   )

   (Labor Code Section 1700.44)

   Petitioner alleges as follows:

   I

   This petition is filed pursuant to the authority of Section 1700.44 of the Labor Code of the State of California.

   II

   At all times mentioned herein __________ (Name Petitioner or Respondent) was and is now a resident of the County of __________, State of California, and an artist (or talent agency) as that term is defined in Section 1700.4 of the Labor Code.

   III

   At all times mentioned herein petitioner (or respondent) acted in the capacity of a talent agency and was (or was not) duly licensed by the laws of the State of California.

   IV

   On or about __________, 19 __________, the parties hereto entered into a(n) __________ contract. (Insert “written” or “oral”. If written, add the following sentence, “A copy of said contract is attached hereto marked Exhibit “A”.”) (If oral, state the terms thereof in this paragraph.)

   V

   A controversy has arisen between petitioner and respondent under said contract in that petitioner contends, and respondent denies.... (Set forth facts of the controversy.)

   WHEREFORE, petitioner seeks the following determination: (Set forth what relief is sought.)

   DATED:

   NAME OF REPRESENTATIVE

   By

   Representative for Petitioner

   or

   Petitioner in Propria Persona

The following form represents the minimum requirements for Petition to Determine Controversy.

NAME OF REPRESENTATIVE

or of PROPRIA PERSONA

Street Address

City and State

Telephone Number

Representative for Petitioner

or

In Propria Persona

BEFORE THE LABOR COMMISSIONER OF THE STATE OF CALIFORNIA

)

Note: Authority cited: Section 1700.29, Labor Code. Reference: Section 1700.44, Labor Code.

History

1. Amendment filed 7-20-89; operative 8-19-89 (Register 89, No. 30). For prior history, see Register 84, No. 11.