How to file a wage claim

An employee or former employee may file an INDIVIDUAL wage claim to recover:

• Unpaid wages, including overtime, commissions and bonuses.
• Wages paid by check issued with insufficient funds.
• Final paycheck not received.
• Unused vacation hours that were not paid upon termination of the employment relationship, e.g., a quit, discharge, or layoff.
• Unauthorized deductions from paychecks.
• Unpaid/non-reimbursed business expenses.
• Reporting time pay/split shift premiums.
• Failure to provide a meal and/or rest period in accordance with the applicable Industrial Welfare Commission Order.
• Liquidated damages for failure to receive minimum wage for each hour worked.
• Waiting time penalties for failure to receive final wages timely upon separation of employment.
• Penalties for paycheck(s) that have bounced or are not negotiable within 30 days of receipt. Penalties for employer’s failure to allow inspection or copying of payroll records within 21 days of request.
• Sick Leave Pay for time accrued and used for which you were not paid (effective July 1, 2015).

If you are a garment worker, you have special rights. Learn more about how to file a garment wage claim.

For workers: view, print or download a guide on how to recover your unpaid wages with the Labor Commissioner's Office. This guide is available in English, Spanish, Chinese, Korean, Russian, Tagalog, and Vietnamese.

Click here to get more information about the policies and procedures for processing a wage claim.

Haga clic aquí para obtener más información sobre las políticas y los procedimientos necesarios para procesar una reclamación salarial.

Download, complete, and print the Initial Report or Claim, DLSE Form 1 (Revised 07/2012). The Form 1 claim form is accompanied by two information sheets to assist claimants. The "Instructions for Filing a Wage Claim" explain which documents and forms should be submitted by claimants in order to file a wage claim. If you need assistance in filling out the Form 1, the "Guide to Completing Initial Report or Claim Form" is a question-by-question guide that presents some basic information about each question on the claim form.

Please be sure to provide all information on the claim form and to sign and date the form in order to avoid delay in the claim process.

English Form 1	English Instructions & Guide
Spanish Form 1 Reporte Inicial o Reclamo	Spanish Instructions & Guide Instrucciones Para Llenar Un Reclamo De Salario> Guía Para Completar El “Reporte Inicial O Reclamo” (Forma DLSE 1)
Chinese Form 1 初次報告或索償	Chinese Instructions & Guide 工資索償說明 “初次報告或索償” 表格完成指南 (DLSE 表格 1)
Korean Form 1 초기 보고서 밎 청구	Korean  Instructions & Guide 임금청구 제기 설명서 "초기 보고서 또는 청구"양식(DLSE 1 양식서)  완료 안내서
Vietnamese Form 1 Khiếu nại hoặc Báo cáo Bước đầu	Vietnamese Instructions & Guide HƯỚNG DẪN NỘP ĐƠN KHIẾU NẠI TIỀN LƯƠNG Hướng dẫn Điền Đơn “Khiếu nại hoặc Báo cáo Bước đầu”(DLSE Form 1)
Tagalog Form 1 Inisyal na Ulat o Paghahabol	Tagalog Instructions & Guide Mga Instruksiyon Para Sa Pagsasampa Ng Isang Paghahabol Ng Sahod Gabay sa Pagkumpleto ng Form para sa “Inisyal na Ulat o Paghahabol” (DLSE Form 1)
Punjabi Form 1 ਸ਼ੁਰੂਆਤੀ ਰਿਪੋਰਟ ਜਾਂ ਦਾਅਵਾ	Punjabi Instructions & Guide ਮਜ਼ਦੂਰੀ ਦਾ ਦਾਅਵਾ ਭਰਨ ਵਾਸਤੇ ਹਿਦਾਇਤਾਂ “ਸ਼ੁਰੂਆਤੀ ਰਿਪੋਰਟ ਜਾਂ ਦਾਅਵਾ” ਫਾਰਮ (DLSE ਫਾਰਮ 1) ਭਰਨ ਲਈ ਗਾਈਡ

IMPORTANT: Along with your completed "Initial Report or Claim" form (Form 1), submit these additional DLSE forms if any of the following situations apply to you:

• DLSE Form 55 for claimants who worked irregular hours:  If your work hours and/or days of work varied per week or were irregular and you are claiming unpaid wages (for non-overtime or overtime hours worked) or meal and rest period violations, then also fill out and submit the DLSE Form 55.
  • Download, print and complete the DLSE-55 (Rev. 10/03).  See Sample DLSE-55.
  • Instructions (DLSE-55)/ Instrucciones (la Forma DLSE 55)

• DLSE Form 155 for claimants with commission claims:  If you are claiming commission pay, then also fill out and submit the DLSE Form 155.
  • Download, print and complete the DLSE-155 (Rev.12/03).  See Sample DLSE-155.
  • Instructions (DLSE-155)/ Instrucciones (la Forma DLSE 155):  Pdf

• DLSE Vacation Pay Schedule for claimants seeking vacation wages:  If you are claiming vacation wages, then also fill out and submit the DLSE Vacation Pay Schedule form.
  • Download, print and complete the DLSE Vacation Pay Schedule . See Sample Vacation Pay Schedule .
    NOTE: Sample is for review only, do not use.
  • Instructions (Recapitulation of Vacation Pay)/ Instrucciones (Recapitulación de Pago de Vacaciones)

• Claimants who are represented: If you are represented by an attorney or other advocate, you may submit a calculation prepared by your attorney or advocate instead of the DLSE Form 55, DLSE Form 155, or DLSE Vacation Pay Schedule required above.

IMPORTANT:  Along with your completed “Initial Report or Claim” form (Form 1), submit one copy of the following documents, if you have them (DO NOT SUBMIT ORIGINAL DOCUMENTS):

• Time records.  Provide a COPY of any records you kept of the hours and dates you worked that support your claim.
• Paychecks and pay stubs.  Provide a COPY of any paychecks and pay stubs you received showing the wages you were paid during your claim period.
• Dishonored (or “bounced”) paycheck(s).  If you were paid with a paycheck that could not be cashed by you because your employer has no account with the bank or insufficient funds in the account from which the check was drawn, provide a COPY of any such dishonored check(s) or other documentation from the bank that indicates the check could not be cashed.
• Notice of employment information.  Provide a COPY if you received a notice from your employer after January 1, 2012 that indicates your basic employment information including your rate of pay, any overtime rate of pay, whether you were paid by the hour, shift, day, week, salary, piece, commission, or otherwise, and your regular payday.
  
  NOTE:  It is the employer’s legal responsibility to keep accurate employee time and payroll records, and to provide employees with itemized wage statements each time they are paid (or at least semimonthly).  In order to file a claim, you are not required to keep your own time records or to have the documents above.  These documents are being requested only if you have them because they may help DLSE better understand your claim.

• Collective Bargaining Agreement.  If your employment was covered by a union contract, provide a COPY of the Collective Bargaining Agreement.

File your claim by mail, fax, email, or in person with the Labor Commissioner’s Office location that handles wage claims for the city/location/community where you performed the work. To locate such office, click here for an alphabetical listing of click here for an alphabetical listing of cities/locations/communities.

We are currently working toward a solution to enable electronic filing via our web application in the future. However at this time, we do allow digital signatures on our claim forms.

You can call our offices. However, you may be able to receive a quicker response by sending us an email. Please send the email to the address for the district office that is handling/was handling your claim. Please note that these email addresses are only for questions having to do with an open or closed wage claim. These email addresses are not for general questions that are not related to a specific wage claim. In your email, please be sure to include your claim number in the subject line. The email addresses are:

If you do not have access to email, you can either call the assigned deputy who is handling your claim or call the main number for the office handling your claim. Please always have your claim number BEFORE you call. Include your claim number in the message.