Virginia Claim for Unpaid Wages Instructions
This file provides essential instructions for completing the 'Claim for Wages' form in Virginia. It details necessary steps, required information, and submission guidelines to ensure your wage claim is processed efficiently. Follow the outlined steps to avoid delays in receiving owed wages.
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How do I fill this out?
Filling out the 'Claim for Wages' form is straightforward. Begin by ensuring all fields are accurately completed and provide supporting documentation. Review your application thoroughly before submission to prevent any processing delays.

How to fill out the Virginia Claim for Unpaid Wages Instructions?
1
Read the instructions carefully before starting.
2
Complete all required fields on the form.
3
Attach any necessary supporting documents.
4
Review your application for accuracy.
5
Submit the completed form by U.S. mail.
Who needs the Virginia Claim for Unpaid Wages Instructions?
1
Employees who have not received their full wages from their employer.
2
Hourly workers seeking compensation for unpaid hours worked.
3
Salaries employees disputing deductions from their salary.
4
Commission-based workers who are owed their commissions.
5
Individuals who need a formal process to recover unpaid wages.
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What are the instructions for submitting this form?
Submit the completed claim form via U.S. Postal mail to the Virginia Department of Labor and Industry at 600 East Main Street, Ste. 207, Richmond, Virginia 23219. Ensure your form is complete, signed, and includes the employer's contact details and the total claimed. Correspondence can also be made through email at laborlaw@doli.virginia.gov.
What are the important dates for this form in 2024 and 2025?
For claims involving wages earned before July 01, 2020, submit your form within two years of wage denial. For wages earned after this date, ensure to file your claim within three years of denial. Timely submissions are critical for recovery.

What is the purpose of this form?
The purpose of the 'Claim for Wages' form is to allow employees in Virginia to formally request the payment of unpaid wages. It offers a structured process for individuals to report wage discrepancies to the Virginia Department of Labor and Industry. Utilizing this form ensures that workers can have their claims reviewed and resolved efficiently, promoting fair wage practices.

Tell me about this form and its components and fields line-by-line.

- 1. Full Name: The claimant's complete name.
- 2. Street Address: The residential address of the claimant.
- 3. City: City of residence.
- 4. Home Phone: Contact number at home.
- 5. Email Address: Email for communication regarding the claim.
- 6. Job Title: Role held at the time of employment.
- 7. Hire Date: Date the claimant started working.
- 8. State: U.S. state of residence.
- 9. ZIP: Postal code.
- 10. Work Phone: Contact number at the workplace.
- 11. Birth Date: Claimant's date of birth.
- 12. Termination Date: Date of employment termination.
- 13. Supervisor's Name: Name of the claimant’s direct supervisor.
- 14. Last Date Worked: The final date the claimant worked.
- 15. Demanded Payment: Indicates whether payment has been demanded.
- 16. Business Name: Name of employer's business.
- 17. Type of Business: Industry of the employer.
- 18. Approx. Number of Employees: Estimation of employees at the business.
- 19. Business Street Address: Physical address of the employer.
- 20. Business Phone: Main contact number for the employer.
- 21. Employer's Contact: Home or cell phone number of employer.
- 22. Mailing Address: Any differing postal address for employer.
- 23. Conducted Business Under Other Names: Specify if the employer operates under different names.
- 24. President/Owner Name: Full name of the company president or owner.
- 25. Owner's Home Address: Residential address of the owner.
- 26. Title: Job title of the company owner.
What happens if I fail to submit this form?
Failing to submit this form accurately can result in delays or rejection of your claim. Ensure all required fields are filled to avoid complications in processing your wage recovery request.
- Incomplete Information: The claim may be returned if required information is missing.
- Failure to Attach Documentation: Not providing necessary supporting documents may hinder your claim.
- Late Submission: Submitting after the deadline can result in permanent loss of claim.
How do I know when to use this form?

- 1. Claiming Hourly Wages: When you were not paid for hours worked.
- 2. Reporting Salary Discrepancies: If salary deductions were made without valid reasoning.
- 3. Recovering Commission Payments: When commissions earned are not correctly paid.
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