0000002504 00000 n Division of Labor Standards State Office Campus Building 12, Room 185 Albany, NY 12240 (888) 4-NYSDOL or (518) 457-9000 (518) 457-8452 (fax) labor.sm.lsclaim.intake@labor.ny.gov Mandatory Overtime for Nurses Complaint Form Instructions: Please type or print legibly. Call (General COVID-19 Questions): 2-1-1. 0000006626 00000 n for a property owned or leased by the State of New Jersey. (24/7) This law is enforced by the National Labor Relations Board, which has the power to file a complaint in court against employers who violate the NLRA. But if your complaint is forwarded to an investigating lawyer member or to the chair of the OAE investigative committee, and the complaint is dismissed after an investigation, you can contact the New Jersey Disciplinary Review Board at P.O. Complaint Forms (the Department does not accept anonymous complaints): Employee Complaint (PW-4) - to be used by a worker to file a claim that he/she was underpaid prevailing wages or supplements on a … H�b```f``�g`e`e`@ (�����c0F���bQ~�"& 6E�, ���j2\00�70�41�``P*�```��;We��D�i0#Y�� i& � 0 3� endstream endobj 43 0 obj 120 endobj 11 0 obj << /Type /Page /Parent 6 0 R /Resources 12 0 R /Contents [ 19 0 R 21 0 R 23 0 R 25 0 R 27 0 R 30 0 R 32 0 R 34 0 R ] /MediaBox [ 0 0 612 792 ] /CropBox [ 0 0 612 792 ] /Rotate 0 >> endobj 12 0 obj << /ProcSet [ /PDF /Text ] /Font << /TT2 15 0 R /TT4 14 0 R /TT5 28 0 R >> /ExtGState << /GS1 38 0 R >> /ColorSpace << /Cs6 16 0 R >> >> endobj 13 0 obj << /Type /FontDescriptor /Ascent 905 /CapHeight 718 /Descent -211 /Flags 32 /FontBBox [ -665 -325 2028 1006 ] /FontName /EHJJEP+Arial /ItalicAngle 0 /StemV 94 /XHeight 515 /FontFile2 36 0 R >> endobj 14 0 obj << /Type /Font /Subtype /TrueType /FirstChar 32 /LastChar 146 /Widths [ 278 0 0 0 0 0 667 0 333 333 0 584 278 333 278 0 556 556 556 556 556 556 556 556 556 556 278 278 0 0 0 556 0 667 667 722 722 667 611 0 722 278 500 0 556 833 722 778 667 0 722 667 611 722 0 944 667 667 611 0 0 0 0 0 0 556 556 500 556 556 278 556 556 222 222 500 222 833 556 556 556 556 333 500 278 556 500 722 500 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 222 ] /Encoding /WinAnsiEncoding /BaseFont /EHJJEP+Arial /FontDescriptor 13 0 R >> endobj 15 0 obj << /Type /Font /Subtype /TrueType /FirstChar 32 /LastChar 146 /Widths [ 278 0 0 0 0 0 722 0 333 333 0 0 0 333 278 0 556 556 0 0 0 0 0 0 556 0 0 0 0 0 0 0 0 722 722 722 722 667 611 778 722 278 556 722 611 833 722 778 667 0 722 667 611 722 667 944 0 667 0 0 0 0 0 0 0 556 611 556 611 556 333 0 611 278 0 556 278 889 611 611 611 0 389 556 333 611 556 0 0 556 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 278 ] /Encoding /WinAnsiEncoding /BaseFont /EHJJEN+Arial,Bold /FontDescriptor 17 0 R >> endobj 16 0 obj [ /ICCBased 39 0 R ] endobj 17 0 obj << /Type /FontDescriptor /Ascent 905 /CapHeight 718 /Descent -211 /Flags 32 /FontBBox [ -628 -376 2034 1010 ] /FontName /EHJJEN+Arial,Bold /ItalicAngle 0 /StemV 144 /FontFile2 35 0 R >> endobj 18 0 obj 694 endobj 19 0 obj << /Filter /FlateDecode /Length 18 0 R >> stream Users that do not have Microsoft Word should use the PDF versions of these forms. If you worked in New Jersey and you believe that your employer has not properly paid you or if you have a complaint against an employer for violating a NJ Labor Law enforced by Wage & Hour, you must file a wage claim in order to start the process. 0000001954 00000 n Some are also available in Microsoft Word format. 0000003066 00000 n This form can now be e-mailed to the individual district offices. Regarding the investigation of anonymous complaints, please note that upon receipt of the completed online forms, the complaints are evaluated and then processed through our internal procedures, which may include on-the-spot inspection by a competent inspector or officer of the Department. General information on how to stay safe, test sites, financial assistance, unemployment, donations, food, and other non-medical needs. Before filing a complaint with the New York State Department of Labor, make sure the situation is an accepted cause of action and that you understand the relevant laws. Click here to download free software.A NOTE ABOUT INTERACTIVE / FILLABLE FORMS: Many of the forms listed below can be filled out electronically and saved to your local drive. * Request for Adjournment / Ready Hold  - page 1 (fillable): * Request for Adjournment / Ready Hold - additional page** Open form and enter in your firm name and contact info. The agency will also provide you the form to file a charge or complaint if you qualify. Those wishing to complain anonymously should print the form and mail it, or report the complaint via phone. An Employee Complaint Form allows an Employee to document and submit a grievance concerning inappropriate or illegal misconduct witnessed in the workplace. The officer will help you determine if you are eligible for protection under the National Labor Relations Board. The OCC-57 Complaint form is provided for the assistance of any person in making a complaint to the NJ Department of Labor & Workforce Development or the NJ Department of Health, and is not intended to constitute the exclusive means by which a complaint may be submitted.. Occupational safety and health complaints under the New Jersey Public Employees Occupational Safety and Health … 0000003301 00000 n Initial The New Jersey Department of Labor and Workforce Development complaints should be directed to their team directly. Follow  instructions on the form. 0000001135 00000 n This form must be mailed or faxed to Bureau of Public Work's Central Office. 0000004073 00000 n The U.S. Department of Labor's Wage and Hour Division (WHD) is responsible for administering and enforcing some of the nation's most important worker protection laws. [1] Occupational Health and Safety: An employee may file a complaint with the New Jersey Department of Labor. 0000003280 00000 n DOL Use Only Claimant’s Full Name Date of Complaint Present Address City State & Zip Claimant’s Phone No. If your employer takes disciplinary action against you for participating in an activities protected under the NLRA, you can submit a charge to the NLRB and have the matter investigated. They are denoted by an asterisk and this image: . 0000005864 00000 n 9 0 obj << /Linearized 1 /O 11 /H [ 1135 232 ] /L 71069 /E 64037 /N 2 /T 70772 >> endobj xref 9 35 0000000016 00000 n New Jersey State Board of Cosmetology and Hairstyling (973) 504-6400 ; Career/vocational/trade school, contact: Department of Labor & Workforce Development (DLWD) (609) 659-9045 Civil rights complaints involving discrimination based on race, color, national origin, age, disability and sex, including sexual harassment, should be filed with: Use the saved form as a template for future Adjournment Requests. 0000060773 00000 n %PDF-1.3 %���� New Jersey. 0000007249 00000 n Equal Employment Opportunity Commission (EEOC) and/or the New Jersey Division on Civil Rights (DCR). To submit a Complaint Inquiry form online, click here. of Labor John Fitch Plaza 13th Floor, Suite D P.O. In addition to filing an internal complaint, individuals have the right to file complaints simultaneously with the U.S. You can visit any of the offices for the Department of Labor and submit a complaint in person. The commissioner will then finalize the labor board complaint. You can find contact details for The New Jersey Department of Labor … 0000004094 00000 n ELECTRONIC CALENDARS, COURTS ON-LINE AND ELECTRONIC FILING FORMS, Temporary Disability & Family Leave Insurance, Governor Phil Murphy • Lt. 0000063450 00000 n 0000006483 00000 n Commissioner New Jersey Dept. After the complaint is received and filed, notice of conference will be issued by the labor board; approximately within 1 to 2 months. An Information Specialist will take the complaint information over the telephone and enter it into our computer data intake system. Call the Wage and Hour Division's toll-free help line: 1-866-4-USWAGE (1-866-487-9243) The New Jersey Department of Labor and Workforce Development is an equal employment opportunity employer and provides equal opportunity programs. The Department of Labor processes the following types of employment related complaints. The State of NJ site may contain optional links, information, services and/or content from other websites operated by third parties that are provided as a convenience, such as Google™ Translate. The majority of the forms available on our website are available in Adobe Acrobat (PDF) format. Note that the paper-based form must be printed and signed, before submission to the Department. If you need to file a wage complaint or report a possible violation of either the Connecticut Family and Medical Leave Act or of the Connecticut Workplace Standard laws, you may now access the necessary forms through our Web site. Auxiliary aids and services are available upon request to assist individuals with disabilities. The Occupational Health and Safety Administration asks that people filing emergency complaints use the phone to assure that it receives the complaint quickly. 0000001573 00000 n Contact the nearest labor board regional office in your jurisdiction where the alleged violation occurred. 0000001045 00000 n The New Jersey Department of Labor and Workforce Development is an equal employment opportunity employer and provides equal opportunity programs. 0000001346 00000 n 0000060695 00000 n 0000004640 00000 n Attorney’s Phone No. 0000007228 00000 n 0000005252 00000 n 0000007835 00000 n To file a wage complaint, you must contact our Call‐Center at 1‐800‐625‐2267 (1‐800‐NC‐LABOR). To view and print PDF forms, you must have Adobe Acrobat Reader which is a free download from Adobe. The State of NJ site may contain optional links, information, services and/or content from other websites operated by third parties that are provided as a convenience, such as Google™ Translate. 0000005231 00000 n Below is a detailed list of information that is helpful for a third-party complainant to contact the Wage and Hour Division (WHD) on behalf of someone else. Auxiliary aids and services are available upon request to assist individuals with disabilities. If there is a conflict of interest, the complaint may be filed with the Division of EEO/AA. Discrimination Complaint Form: scf-4 : PDF. 0000004661 00000 n The Department of Labor does not accept anonymous complaints; you must identify yourself in order to lodge a complaint. 0000006647 00000 n Official Site of the State Of New Jersey. CM-972 (Form Name - Application for Approval of a Representative's Fee in a Black Lung Claim Proceeding Conducted by The U.S. Department of Labor; Agency - Office of Workers' Compensation Programs - Division of Coal Mine Workers' Compensation) Please note that interactive Word forms do not convert properly into other word processsing software. 0000001732 00000 n Follow instructions on the form. H�tT�n�0}�+�2�p|l�ݤ�h��f��P�� Hi��i���w�&�[+$. Box 962, Trenton, NJ 08625 to request an appeal form. The conference is an opportunity for the employee, the employer, and/or both parties’ attorneys to attend and answer questions before a commissioner. WHD Response to COVID-19. 0000003027 00000 n Google™ Translate is an online service for which the user pays nothing to obtain a purported language translation. Google™ Translate is an online service for which the user pays nothing to obtain a purported language translation. ComplaintsBoard.com is not affiliated, associated, authorized, endorsed by, or in any way officially connected with The New Jersey Department of Labor and Workforce Development Customer Service. The Complaint Inquiry form should be used to report noncompliance with wage and hour or human rights laws. WHD is committed to ensuring that workers in this country are paid properly and for all … Having trouble finding your answer on our website? 0000008195 00000 n Also use this form if you provide building services (e.g. To obtain a paper-based copy of the form, click here. Schedule of Disabilities E-Calendars, COURTS on-line  and E-Filing Miscellaneous. Phone: 609-292-2323 Fax: 609-633-9271. ΑNONYMOUS COMPLAINT FORM. Box 110 Trenton, NJ 08625-0110. The structure of such complaint forms make for a formalized and clear framework of facts, and Employers and Human Resource personnel utilizing these forms are presented with a systematic process for interpreting the issue at hand. Date of Injury Employer In order for the N.C. Department of Labor’s Wage and Hour Bureau to assist an employee with a wage dispute, a complaint must be filed with this office. This form can now be e-mailed to the individual district offices. Save the form onto your computer by hitting Save As. NJ Department of Labor & Workforce Development Division of Public Safety & Occupational Safety & Health Office of Public Employees’ Safety DISCRIMINATION COMPLAINT FORM Log No. 0000054556 00000 n Return to nj.gov. In the above example, the claimant had submitted a complaint to the labor board that alleged only $1,274.97 in unpaid straight time and that lacked the required Form 55 calculation exhibit. Depending upon the type of complaint, you may need to provide certain documents such as W-2, paystubs, and/or any other supporting documents verifying the complaint. For further instructions and helpful hints on using interactive forms, click here. Labor Market Information: Directions/Office Information . 0000028094 00000 n The New Jersey Department of Labor and Workforce Development is an equal employment opportunity employer and provides equal opportunity programs. 0000007814 00000 n 0000001367 00000 n The complaint must be filed within 180 days of the retaliatory action. Governor Sheila Oliver, N.J.S.A 34:15-95.6 Worksheet for Supplemental Benefit Calculations, Dependency Claim Petition -To Convert Voluntary Tender to Formal Judgment. 0000063662 00000 n trailer << /Size 44 /Info 7 0 R /Root 10 0 R /Prev 70763 /ID[<24f5559b5f02a400dbe26dffabeb2f2c><15472271a1db870b703ce0dd7f7501dd>] >> startxref 0 %%EOF 10 0 obj << /Type /Catalog /Pages 6 0 R /Metadata 8 0 R /PageLabels 5 0 R >> endobj 42 0 obj << /S 46 /L 133 /Filter /FlateDecode /Length 43 0 R >> stream janitor, security guard, window cleaner, etc.) Step 2: Complete the "Complaint of Discrimination in Employment Under Federal Government Contracts" form and submit it by: filing the complaint form electronically with the appropriate OFCCP Regional Office; or; mailing or faxing the complaint form to the appropriate OFCCP Regional Office; or; filing the complaint form in person with any OFCCP District or Area office. 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