Notice of Designation of Representative

• Legal Form Number: 1.07a
• Section: Office of Congressional Workplace Rights (United States)

Office of Congressional Workplace Rights

Notice of Designation of Representative Form

OCWR Form 1.07(a)

Employee name(s): ____________________________________________

Employing office: _____________________________________________

OCWR Case no. (if any): _______________________________________

Instructions

A party wishing to be represented by an entity, a firm, or a different individual must file

this written Notice of Designation of Representative Form with the Office of

Congressional Workplace Rights (OCWR). Only one person, firm, or other entity may be

designated as a representative for a party for the purpose of receiving service, unless the

hearing officer assigned to the case or the OCWR Executive Director approves a written

request to have more than one representative. A representative may be, but is not required

to be, an attorney. If the representative is an attorney, he or she may sign this Notice of

Designation of Representative Form on behalf of the party.

The individual or entity listed as the designated representative shall remain in that

capacity and stay on file at the OCWR unless or until the represented party—or the

representative with notice to the party—informs the OCWR Executive Director in

writing that this designation is modified or revoked. All service of documents shall be

sent to the designated representative unless or until such time as the represented party—

or the representative with notice to the party—specifies otherwise and informs the

Executive Director in writing that the designation of representative has been modified or

revoked.

Please complete the next page of this form and submit it to the OCWR by one of the

following methods: email (OCWRefile@ocwr.gov), fax (202-426-1913), or hand-delivery

to the Library of Congress, John Adams Building, 110 Second Street, SE, Room LA-200,

Washington, DC 20540.

Office of Congressional Workplace Rights

110 Second Street, SE, Room LA -200 | Washington, DC 20540-1999

(202) 724-9250 (O) | (202) 426-1913 (F)

www.ocwr.gov

03/2020