Filing a Wage Claim, Instructions and Form

Before filing, did you discuss your situation with your employer or former employer? If you haven't yet talked with your employer or former employer about the issue in dispute, do so. Communication is the key. We have found that some disputes can be resolved if both parties take the time to communicate with one another. We have found this to be the case especially with final paycheck situations - your check may be issued and waiting for you to pick it up or the employer may be waiting for a call from you to provide your new address.

We also understand, however, that not all issues can be resolved this easily. If this is the case, you may proceed by filing a wage claim with our office.

The claim form contained on this website is in a .PDF format. In order to access it, you may need to download the FREE Acrobat Reader.

COMPLETING THE WAGE CLAIM FORM:

There are two forms available.
The first must be printed and filled out by typing or printing. Download Printable Form
The second form is interactive. Use your tab key to navigate through the form, enter your information, and then print the form. Download Interactive Form.
Read carefully and answer all questions on the wage claim form.

Your claim must be filled out completely and legibly (front & back). Please print or type.

- provide your name, address, social security number and telephone number where you can be reached during the day.

- provide your employer's name, name of business, correct address and telephone number.

- provide a dollar amount you are claiming is due, even if it is just your best estimate.

- provide inclusive dates in which you are claiming the wages.

***without this information, your claim will be returned.

Attach any documentation that will help substantiate your claim. You may want to include a detailed letter explaining the details of your claim.

Regardless of the form used, return the original, signed and notarized Wage Claim form to the Wage & Hour Unit. Our address is provided at the top of the claim form. Faxed claims will not be accepted as we need the original notarized claim form.

Other options for obtaining a form are contacting your local job service office, or by contacting our office directly at (406) 444-5600.

-	provide your name, address, social security number and telephone number where you can be reached during the day.
-	provide your employer's name, name of business, correct address and telephone number.
-	provide a dollar amount you are claiming is due, even if it is just your best estimate.
-	provide inclusive dates in which you are claiming the wages.