IMPORTANT: This report is mandatory under P.L. 86-257, as
amended. Failure to comply may result in criminal prosecution,
fines, or civil penalties as provided by 29 U.S.C. 439 or 440.
Required of persons, including Labor Relations Consultants and
Other Individuals and Organizations, under Section 203(b) of
the
Labor-Management Reporting and Disclosure Act of 1959, as
amended (LMRDA).
Office of Labor-Management Standards
U.S. Department of Labor
For Official Use Only
E
OLMS
Read the instructions carefully before completing this report.
1.a. File Number: C-69678
Amended:
2.
Name and mailing address (including Zip Code):
Name:Tracy Lee Schrey
Title:Senior Consultant
Organization:Valens Business Services, LLC
P.O. Box., Bldg., Room No., if any:
Street:15421 Georgia Oak Place
City:Winter GardenState:FL
ZIP code:34787
3.
Other address where records necessary to
verify this report are kept:
Name:Christopher Cimino
Title:CEO
Organization:CACR Labor Education Services
P.O. Box., Bldg., Room No., if any:
Street:134 East Adams Street
City:ElmburstState:IL
ZIP code:60126
4.
Date fiscal year ends:Dec /31
5.
Type of person
a.
Individual b.
Partnership
c.
X
Corporation C d.
Other
Specify:
Nature of Agreement or Arrangement
6.
Full name and address of employer with whom made (include ZIP Code):
Name:Dawn Krutkramer
Organization:Rogers Behavioral Health
Trade Name, if any:
P.O. Box., Bldg., Room No., if any:
Street:34700 Valley Road
City:OconomowocState:WI
ZIP code:53066
7.
Date entered into03/25/2023
8.
Name of person(s) through whom made:
Name:Dawn Krutkramer
Signature and Verification
Each
of the undersigned declares, under penalty
of
perjury
and
other
applicable penalties of law, that all of the
information
submitted in this report (including the information
contained in
any accompanying documents) has been examined by
the
signatory
and
is, to the best of the undersigned's
knowledge
and
belief,
true, correct, and complete. (See Section
VII on
penalties in the
instructions.)
13.
SIGNED:
Tracy L Schrey
Title:
PRESIDENT
Date:
May 05, 2023
Telephone Number:
717-877-1376
14.
SIGNED:
Tracy L Schrey
Title:
TREASURER
Date:
May 05, 2023
Telephone Number:
717-877-1376
Form LM-20 (2003)
9.
Check the appropriate box(es) to indicate
whether an object
of the activities undertaken is directly
or
indirectly:
a.
X
To persuade employees to exercise or not to
exercise, or persuade employees as to the manner of
exercising, the right to organize and bargain collectively
through representatives of their own choosing.
b.
To supply an employer with information
concerning the activities of employees or a labor
organization in connection with a labor dispute involving
such employer, except information for use solely in
conjunction with an administrative or arbitral proceeding
or
a criminal or civil judicial proceeding.
10.
Terms and conditions.
(Explain in detail;
see
instructions.
Written agreements must
be attached.):
Written Agreement/Arrangement
Met with employees to explain their rights under the NLRA and answer any questions.
Specific Activities to be performed
Activity1
11. For each activity, separately list in detail the information required.
(See instructions.)
a. Nature of activity:Met with employees to explain their rights under the NLRA and answer questions.
11.b.Period during which activities
performed:
03/27/2023 - 04/13/2023
11.c. Extent of performance:
Completed
11.d.
Name and address of person(s) through
whom
activities were performed or will be performed:
Name:Tracy Schrey Organization:Valens Business Services
P.O. Box, Bldg., Room No., If any:Street:15421 Georgia Oak PlaceCity:Winter GardenState:FLZip:34787
12.a. Identify subject groups of employees:
Professionals and Non-Professionals
12.b. Identify subject labor organizations:
NATIONAL UNION OF HEALTHCARE WORKERS( NUHW STAFF UNITED (NSU)) - 545779