Labor & Employment Law
INSTRUCTIONS FOR COMPLETING "CLAIM FOR WAGES" FORM
PLEASE READ THESE INSTRUCTIONS CAREFULLY
The attached form must be completed and returned in order for your claim to be investigated. Fill in all areas completely; if necessary, use a separate sheet of paper to provide additional information. Attach copies of all documents which will support your claim. Incomplete forms will be returned, causing a delay in the investigation of your claim. If you have not requested payment of your wages from your employer, you must do so before filing a claim. Only after you have been denied your wages should you file a claim with this office.
EMPLOYEES PAID BY THE HOUR:
If you are claiming wages based on an hourly wage, include the dates, days, and hours worked for which you were not paid; include the gross amounts of wages you are claiming. Please provide documentation, such as a paycheck stub, to verify that the rate of pay you are claiming has been previously paid to you. Otherwise, our enforcement may be restricted to the requirements of the Virginia minimum wage of $7.25 per hour, if applicable.
EMPLOYEES PAID BY SALARY:
If you are claiming wages based on a salary rate, include the maximum number of hours and days you were required to work to receive the salary rate. Please provide documentation, such as a paycheck stub, to verify that the salary you are claiming has been previously paid to you. Provide dates, days, and hours worked for which you were not paid and include the gross amount of wages you are claiming.
EMPLOYEES PAID BY COMMISSION:
State the total amount of wages you claim are due and show us how you arrived at the dollar amount of your claim. Provide a description of your commission agreement including the commission rate you were to receive. Tell us what you had to do to earn the commission and under what circumstances the commission would become due and payable. Account for any and all "draws" you may have received. Identify each specific account for which you seek payment of a commission and state the dollar amount of the commission you claim for each account. Please provide documentation such as a paycheck stub or an employment agreement to verify that the commission rate you are claiming has been previously paid to you.
Continue to "Claim for Wages" Instructions - Page 2