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Minimum Wage and Overtime Complaint Form

Description

This form is used to file complaints under the Pennsylvania Minimum Wage Act of 1968, P.L. 11, No. 5.
 
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

Electronic Submission

The Online Version of the form.

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

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.

District Offices

Once your claim as been accepted, it will be assigned to one of the following District Offices based on the county of the employer.
 
Altoona District Office
Suite 200, 2nd Floor
1130, 12th Avenue
Altoona, PA 16601
Toll Free: 1-877-792-8198
Harrisburg District Office
1302-A Labor & Industry Bldg
651 Boas Street
Harrisburg, PA 17121
Telephone: 717-705-5969
Philadelphia District Office
110 North 8th St
Suite 203
Philadelphia, PA 19107
Telephone: 215-560-1858 or
1-877-817-9497
Pittsburgh District Office
301 5th Avenue
Pittsburgh, PA 15222
Scranton District Office
Scranton State Office Bldg
100 Lackawanna Ave -Rm 201B
Scranton, PA 18503
Telephone: 570-963-4577
 
Please direct your questions regarding minimum wage and overtime complaints to the Bureau of Labor Law Compliance, with offices in Harrisburg, Philadelphia, Pittsburgh, and Scranton.