Prevailing Wage Complaint Form

Print and mail this form to:
Division of Labor Standards
Attn: Prevailing Wage Program
P.O. Box 449, Jefferson City, MO 65102-0449
Phone: 573-751-3403   Fax: 573-751-3721

Complainant Information

* The "Asterisk" Denotes Required Field
~ Please Provide e-mail address for confirmation and corespondence about this complaint.

Type of Complaint

* Check Type of Complaint
Underpayment of Wages
Incorrect occupational title of workers for type of work performed
Underpayment of Fringe Benefits
Health and Welfare
Failure to Pay Benefits
No Wage Determination Issued for Project
Failure to Post Wage Determination
Failure to Report Wage Subsidy, Bid Supplement or Rebate
Failure to complete construction safety training pursuant to Section 292.675

Project Identification - Complaint Against

* Are you currently employed by this contractor?
If not, have you ever been employed by this contractor in the past?
Type of project:
* Project Start and End Date (mm/dd/yyyy) Pursuant to RSMo. 290.290 MODLS can only pursue administrative action for one (1) year from final project payout.
Supporting Documentation
If you are unable to attach the documentation electronically, please indicate below in the "Summary of Complaint" a brief description of documentation you have. An investigator may contact you and ask to have it mailed or faxed to our agency if the documentation is needed.