Wage Complaint Form

Description

This form is used to file complaints under the Pennsylvania Wage Payment and Collection Law, Act of 1961, P.L. 637, No. 329.

In an effort to expedite your complaint, the Bureau of Labor Law Compliance encourages you to take advantage of the online or electronic submission of the complaint form.

If you choose instead to return a hardcopy version of this form (manual submission), all pages must be completed. Additional information that may be needed and applicable to the specific Law under which your compliant is made may be attached.

Manual Submission

Download this PDF Version if you would like to print out the form and submit it by fax to 717-787-0517, or by mail to:

Bureau of Labor Law Compliance
1301 Labor and Industry Building
651 Boas Street
Harrisburg, PA 17121

The Wage Complaint and Collection Law claim form has been translated into Spanish. To download a printable version of the Formulario De Reclamo De Sueldo, please click here.

Electronic Submission

Online Version

Tips to complete the online form:

• The form must be completed within 20 minutes, or the system will timeout. Please ensure you have your answers ready before starting the application. 
  
• Questions under the “Complaint Details” section that require a dollar amount may only include numbers and periods. Commas or dollar signs are not accepted and may cause form submission errors.

La solicitud en línea está actualmente en un proceso de mantenimiento. Ésta estará de regreso pronto. Hasta entonces, por favor use el formulario impreso ubicado arriba.

If you have additional information including attachments, they can be faxed or mailed. Please refer to the instructions provided below under "Manual Submission."