Wage Theft

Wage Theft occurs when an employer does not pay an employee everything they are owed by law.

Examples of Wage Theft include: paying less than the minimum wage, requiring or allowing work off the clock without pay, not paying time-and-a-half for overtime, not paying earned tips, unlawful paycheck deductions, not paying a final check upon separation of employment, and misclassifying employees as independent contractors. If any of these situations apply to you, please fill out the Complaint Form below.

If you are in possession of an Employment or Independent Contractor Agreement, or any other employer policy or handbook that is relevant to your complaint, please submit it along with this form by attaching it at the bottom at “Attach Files.”

* indicates required field

Language:

Your Name

PrefixFirst NameLast NameSuffix

Your Employer Name

Date Started

Date

Are you currently employed by this employer?

If no, Date Ended?

Date

Reason for termination of employment:

Your Job Title

Your Hourly Rate (or salary):

ex. $15/hour OR $200/day OR $700/week

Your Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Your Primary Phone

Your Alternate Phone

Your Email

Confirmation Emailexample@example.com

Employer Industry:

ex. Manufacturing, agriculture, janitorial, construction

Employer Size – approximately how many people work for this company?

Employer Address

Street Address

Street Address Line 2

CityState

Zip Code

Supervisor Name

Supervisor Phone Number

Supervisor Email

example@example.com

Are you concerned that your employer would retaliate against you for contacting this Office and prefer to remain anonymous if the Office chooses to contact this employer regarding the claimed practice?

Have you contacted another government agency?

Which one?

Did you file a complaint?

What was the result?

Are you a member of a union?

Have you filed a lawsuit?

If so, with which court?

What was the result?

Are other employees affected by this practice?

How many?

How long has this violation occurred?

Description of Complaint (check all that apply)

Explanation of the Problem:

Did you complain about the issue to your employer?

If so, to whom did you complain and when?

Was any action taken?

If so, please explain:

Are there any potential witnesses?

If so, please provide their names and phones numbers:

What do you want your employer to do?

If you are in possession of an employment or independent contractor agreement or any other relevant documents, please attach here:

Attach Files

Max total size limitation: 10 MB. Accepted file types: pdf, doc, docx, xls, xlsx, csv, mp3

By choosing ‘Accept’ below, I acknowledge and/or consent to the following terms: (a) the information I am providing will be used by the Minnesota Attorney General’s Office (“AGO”) to attempt to resolve the issue about which I am contacting the Office, to communicate with me, and to otherwise assist in enforcing the law; (b) the information I provide will be accessible to AGO staff whose work assignments reasonably require access, to the state or legislative auditors, to other entities authorized by state or federal law, to persons authorized pursuant to a court order, and to others subject to my consent; (c) for the purposes described herein, I consent to the AGO disseminating information I provide to the person or entity complained against, to other law enforcement agencies, and to other consumer-assistance agencies; (d) I am not legally required to provide the information I have submitted or to consent to its release, but my failure to do so may make it more difficult to resolve my concern; (e) I understand that the AGO does not control the use or dissemination of information provided to third parties pursuant to my consent.

Wage Theft Complaint Form

Your Information

Employer Information

Other Information

Explanation & Resolution