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Wage and Hour

Wage and Hour Division

Employment Wage Complaint


Please read these instructions Before Filing a Wage Complaint.

A complaint alleging non-payment of wages or fringe benefits must be filed within 12 months of the alleged violation.

If you have not been paid at least minimum wage or you have not been paid overtime, you may file a complaint up to 3 years from the date of the alleged violation.

The online Employment Wage Complaint form may be submitted if you have not been paid your wages or fringe benefits, or if you have not been paid minimum wage or overtime.

Provide any additional information you may have by Mail, Fax or Email (Contact information is provided at the bottom of this page). Attach copies of any document which supports your claim such as; an employment contract, wage agreement, commission statements, invoices, time records, list of hours worked, check stubs, written fringe benefit (vacation pay, sick pay, holiday pay, paid time off, bonus, expense reimbursement) policy or contract.


EMPLOYEE INFORMATION

*    = Required Fields




(Optional - This is not a secure site)

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If you provide your email, you will receive an email with this Wage Complaint as an attached PDF.


ADDRESS WHERE YOU WORKED



List your Rate of Pay (Provide a Copy of your Check Stub)


EMPLOYER INFORMATION

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CLAIM WILL BE RETURNED IF AN AMOUNT and PERIOD IS NOT PROVIDED

Period of Claim
Your Reason for Filing this Claim Amount Claimed Start End
WAGES mm/dd/yyyy mm/dd/yyyy
Hourly
Salary
Commissions
Piece Rate/Other
Unauthorized Deductions
FRINGE BENEFITS (Provide written policy or contract)
Vacation Pay
Paid Time Off
Holiday Pay
Sick Pay
Expense Reimbursement
Bonus
Minimum Wage
Overtime
Total Gross (before tax deductions) Amount Claimed

Yes No

PLEASE ANSWER THE FOLLOWING

Yes No

MAIL, EMAIL, OR FAX COPIES OF INFORMATION TO:

Wage and Hour Division
PO Box 30476
Lansing, MI 48909-7976
Fax Number: (517) 322-6352
Email: whclaim@michigan.gov

Filing this complaint does not guarantee payment, or a finding in your favor.

If you are submitting additional documentation by mail to our office, write; "Web filed" at the top, your first and last name, the employer's name and include the online reference number provided at the bottom of the second page of the pdf document sent to you as an attachment to the notification email.

By submitting this claim form online, I certify to the best of my knowledge and belief, this is a true statement of wages or fringe benefits due me. I understand that my claim will be investigated and there is no guarantee that the wage and / or fringe benefits will be found due. I will inform the department if any of the following occur; change of name, address and / or telephone number for myself; or change of employer address; or direct payment and / or settlement of claim.


If you provide an email address, you will receive an email notification that your online complaint form was received, and a copy of your complaint form in pdf format as an attachment.

It may take up to 72 hours for you to receive notification of submission; please do not submit the complaint more than once.