A. Format:

STATE OF NEW MEXICO

BEFORE THE OCCUPATIONAL HEALTH AND SAFETY REVIEW COMMISSION

[NAME OF COMPLAINANT OR PETITIONER],

[complainant/petitioner],

v. No. [insert case no.]

[NAME(S) OF RESPONDENT(S)],

respondent[s].

NOTICE TO AFFECTED EMPLOYEES

(PROPOSED SETTLEMENT OF CASE)

The attached settlement agreement has been entered into by the [signing] parties. Any affected employee [or representative of affected employees] who objects to the settlement agreement should file a written objection, including reasons, by hand-delivery to the commission secretary at [street address], or by first class mail addressed to [mailing address]. Objections must be received by the commission secretary within twenty (20) days after filing of the settlement agreement. Specific procedures for objection are set forth in 11 NMAC 5.5 [now 11.5.5. NMAC], Occupational Health and Safety - Review Commission Procedures, a copy of which may be obtained from the commission secretary by calling [phone no.]. Copies of all documents filed in this matter may be inspected at [location].

[Date of posting] [Signature] ________________________________

[Typed or printed name]

B. Usage note: This document must be posted, with an attached copy of the settlement agreement, in accordance with Section 503.D[ now Subsection D of 11.5.5.503 NMAC]. Neither the original nor a copy should be filed with the department or the commission.

[1/1/84, 8/12/93, 1/1/94, 10/1/94, 1/1/96; Recompiled 11/30/01]