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 or an employment contract, 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 $6.55 (07/24/08) 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 or an employment
contract, 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.
ACCEPTANCE OF THIS CLAIM DOES NOT GUARANTEE COLLECTION OF WAGES
Upon acceptance of your claim by this Department, do not assume that
your claim is valid and collectible. In cases where the employer disputes
your charges, it will be YOUR responsibility to offer objective support
for the amount and validity of your claim. Also, you must provide the
company's complete name and address along with the owner's or company
representative's full name and address.
Since wage claims are handled by field investigators, we do not provide
periodic progress reports. Requests for progress reports only hinder the
prompt resolution of your claim. When a final determination has been made,
or if additional information is needed, you will be notified.
Please notify the appropriate regional office immediately of any change
in your address, telephone number, or if you receive payment from your
employer.
