Free U.S. DoL Form in PDF

Free U.S. DoL Form in PDF

The U.S. Department of Labor (DoL) form is a vital document used by employees to report wages, file for benefits, or comply with federal regulations. Its significance can't be overstated, as it directly affects an individual's employment rights and benefits. To ensure your rights are protected, click the button below to fill out the form accurately.

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In navigating the complexities of employment within the United States, individuals and employers alike often encounter the necessity of engaging with various forms issued by the Department of Labor (DoL). These documents play a crucial role in ensuring compliance with federal labor laws, covering a wide range of issues from wage and hour regulations to workplace safety and health standards. The U.S. DoL forms serve as essential tools for the submission of complaints, reporting of injuries or workplace hazards, and requests for wage determination, among other purposes. As such, they facilitate communication between the government, employers, and employees, thereby helping to maintain fair labor practices across the nation. Understanding the specific function and requirements of each form is imperative for effective navigation through the administrative aspects of employment and labor law compliance.

Preview - U.S. DoL Form

U.S. Department of Labor

 

PAYROLL

 

Wage and Hour Division

 

(For Contractor's Optional Use; See Instructions at www.dol.gov/whd/forms/wh347instr.htm)

 

 

 

Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number.

Rev. Dec. 2008

NAME OF CONTRACTOR

OR SUBCONTRACTOR

 

ADDRESS

OMB No.:1235-0008

 

 

 

 

Expires: 04/30/2021

 

 

 

 

 

PAYROLL NO.

 

FOR WEEK ENDING

PROJECT AND LOCATION

PROJECT OR CONTRACT NO.

(1)

NAME AND INDIVIDUAL IDENTIFYING NUMBER (e.g., LAST FOUR DIGITS OF SOCIAL SECURITY NUMBER) OF WORKER

(2)

NO. OF WITHHOLDi NG TXE EMP IONS

(3)

WORK

CLASSIFICATION

(4) DAY AND DATE

(5)

(6)

(7)

 

 

(8)

 

(9)

 

 

 

 

 

 

 

 

T.

 

 

 

 

 

DEDUCTIONS

 

 

ORS

 

 

 

 

 

 

 

NET

 

 

GROSS

 

WITH-

 

 

WAGES

OT.

 

 

 

 

 

TOTAL

RATE

AMOUNT

 

HOLDING

 

TOTAL

PAID

HOURS WORKED EACH DAY

HOURS

OF PAY

EARNED

FICA

TAX

OTHER

DEDUCTIONS

FOR WEEK

O

 

 

 

 

 

 

 

 

S

 

 

 

 

 

 

 

 

O

 

 

 

 

 

 

 

 

S

 

 

 

 

 

 

 

 

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While completion of Form WH-347 is optional, it is mandatory for covered contractors and subcontractors performing work on Federally financed or assisted construction contracts to respond to the information collection contained in 29 C.F.R. §§ 3.3, 5.5(a). The Copeland Act

(40 U.S.C. § 3145) contractors and subcontractors performing work on Federally financed or assisted construction contracts to "furnish weekly a statement with respect to the wages paid each employee during the preceding week." U.S. Department of Labor (DOL) regulations at

29 C.F.R. § 5.5(a)(3)(ii) require contractors to submit weekly a copy of all payrolls to the Federal agency contracting for or financing the construction project, accompanied by a signed "Statement of Compliance" indicating that the payrolls are correct and complete and that each laborer or mechanic has been paid not less than the proper Davis-Bacon prevailing wage rate for the work performed. DOL and federal contracting agencies receiving this information review the information to determine that employees have received legally required wages and fringe benefits.

Public Burden Statement

We estimate that is will take an average of 55 minutes to complete this collection, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. If you have any comments regarding these estimates or any other aspect of this collection, including suggestions for reducing this burden, send them to the Administrator, Wage and Hour Division, U.S. Department of Labor, Room S3502, 200 Constitution Avenue, N.W. Washington, D.C. 20210

(over)

Date

I,

(Name of Signatory Party)

 

(Title)

do hereby state:

(1) That I pay or supervise the payment of the persons employed by

(b)WHERE FRINGE BENEFITS ARE PAID IN CASH

Each laborer or mechanic listed in the above referenced payroll has been paid, as indicated on the payroll, an amount not less than the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as listed in the contract, except as noted in section 4(c) below.

(c)EXCEPTIONS

(Contractor or Subcontractor)

on the

EXCEPTION (CRAFT)

EXPLANATION

; that during the payroll period commencing on the

(Building or Work)

day of

 

,

 

, and ending the

 

day of

 

,

 

,

all persons employed on said project have been paid the full weekly wages earned, that no rebates have been or will be made either directly or indirectly to or on behalf of said

from the full

(Contractor or Subcontractor)

weekly wages earned by any person and that no deductions have been made either directly or indirectly from the full wages earned by any person, other than permissible deductions as defined in Regulations, Part

3 (29 C.F.R. Subtitle A), issued by the Secretary of Labor under the Copeland Act, as amended (48 Stat. 948,

63 Stat. 108, 72 Stat. 967; 76 Stat. 357; 40 U.S.C. § 3145), and described below:

(2)That any payrolls otherwise under this contract required to be submitted for the above period are correct and complete; that the wage rates for laborers or mechanics contained therein are not less than the applicable wage rates contained in any wage determination incorporated into the contract; that the classifications set forth therein for each laborer or mechanic conform with the work he performed.

(3)That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a State apprenticeship agency recognized by the Bureau of Apprenticeship and Training, United States Department of Labor, or if no such recognized agency exists in a State, are registered with the Bureau of Apprenticeship and Training, United States Department of Labor.

(4)That:

(a)WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS, OR PROGRAMS

in addition to the basic hourly wage rates paid to each laborer or mechanic listed in the above referenced payroll, payments of fringe benefits as listed in the contract have been or will be made to appropriate programs for the benefit of such employees, except as noted in section 4(c) below.

REMARKS:

NAME AND TITLE

SIGNATURE

 

 

THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE SECTION 1001 OF TITLE 18 AND SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE.

Document Specs

Fact Number Fact Name Description Governing Law(s)
1 Form Purpose The U.S. Department of Labor (DoL) forms serve various purposes including employment verification, wage reporting, and workplace condition documentation. N/A
2 Form Usage These forms are used by employers, employees, and sometimes by government agencies to ensure compliance with federal labor laws. N/A
3 Online Submission Many DoL forms can be submitted online through the Department's website, streamlining the submission process. N/A
4 Variety of Forms There is a wide range of forms for different purposes, including but not limited to FMLA requests, wage reporting, and safety violation reporting. N/A
5 State-Specific Forms Some forms are specific to certain states, requiring additional information or compliance with state laws. Applicable State Labor Laws
6 Accessibility DoL forms are designed to be accessible to individuals with disabilities, aligning with federal accessibility standards. N/A
7 Updates and Revisions Forms are periodically updated or revised to reflect changes in federal labor laws or procedures. N/A
8 Confidentiality Information provided on DoL forms is kept confidential and is protected under federal law. Privacy Act of 1974 and other applicable laws
9 Penalties for Non-compliance Failing to properly fill out and submit DoL forms can result in penalties, including fines and legal action. Applicable Federal Labor Laws

Instructions on Writing U.S. DoL

Once you have decided to proceed with an action that requires completing a U.S. Department of Labor (DoL) form, understanding the step-by-step process of filling it out correctly is vital. This procedure ensures that your submission is accurate and compliant with the requirements, facilitating a smoother processing experience. Preparing to fill out a U.S. DoL form can seem daunting, but by breaking down the process into manageable steps, you can approach it with confidence. Below are the steps needed to accurately complete the form. Please note that these steps are general guidance, as the specific DoL form content was not provided.

  1. Gather all necessary information and documents related to your case or the specific situation requiring the form. This might include personal identification, employment records, any previous correspondence with the DoL, and other relevant details or documents.
  2. Access the correct form. This can usually be done by visiting the U.S. Department of Labor's official website and navigating to their forms page. Make sure you're downloading the latest version of the form you need.
  3. Read through the entire form before you start filling it out. This initial review helps you understand the scope of information required and ensures you have all necessary documents and information at hand.
  4. Begin filling out the form, starting with the easy sections first. These usually include personal information such as your name, address, and contact details. Ensure that all the information you provide is accurate and matches the documents you're submitting alongside the form.
  5. Proceed with the more detailed sections, which may require specific details about your employment, any incidents or disputes, and other specialized information. Take your time with these sections to ensure that all the information provided is clear and precise.
  6. If the form allows or requires additional documentation for clarification or evidence, prepare these documents accordingly. Ensure that they are legible, accurate, and relevant to the case at hand.
  7. Before finalizing the form, review it thoroughly. Check for any mistakes, inaccuracies, or missing information. This step is crucial for preventing delays or issues with the processing of your form.
  8. Follow the specific submission guidelines provided by the U.S. Department of Labor for the form. This may include submitting it online, via email, or through postal mail. Ensure that you have the correct submission address or email if applicable.
  9. Keep a copy of the completed form and any correspondence or documentation you send for your records. This is important for future reference or in case of any disputes or follow-up required.
  10. Finally, after submitting the form, make sure to follow up if you have not received a confirmation of receipt or any communication regarding your submission within a reasonable timeframe.

By carefully following these steps, you can complete and submit your U.S. DoL form with greater ease and accuracy. Remember, attention to detail and thorough preparation are key to ensuring that your engagement with the Department of Labor proceeds as smoothly as possible. Should you encounter any difficulties or require further assistance, consider reaching out for professional advice or consulting the U.S. Department of Labor's resources for guidance.

Understanding U.S. DoL

What is the U.S. Department of Labor (DoL) form used for?

The U.S. Department of Labor (DoL) form serves various purposes, depending on the specific form in question. Common uses include reporting workplace injuries, requesting family and medical leave, applying for employment training programs, and submitting wage and hour complaints. These forms are integral to ensuring employers comply with labor laws and protect employee rights.

Where can I find the right DoL form for my needs?

DoL forms can be found on the U.S. Department of Labor's official website. The website is organized to help users easily navigate to the specific section relevant to their needs, such as Wage and Hour Division, Occupational Safety and Health Administration, or Employee Benefits Security Administration, among others, where they can find and download the necessary forms.

How do I submit a DoL form?

Submission procedures can vary depending on the specific DoL form. Many forms can be submitted online through the Department of Labor's website, while others might require mailing or hand delivery to a specified office. Always check the form's instructions carefully for the recommended submission method.

Is there a fee to file a DoL form?

Most DoL forms do not require a filing fee. However, it's crucial to read the instructions for your specific form carefully, as there could be exceptions. The purpose behind this is to ensure that financial barriers do not prevent individuals from exercising their rights and obtaining the protection or services they need.

What information do I need to complete a DoL form?

The information required will vary by form but generally includes personal information, employment details, and specific information pertaining to the issue or request at hand. It’s essential to provide accurate and complete information to avoid delays. Before you start, it's advisable to gather all relevant documents and information to ensure you can fill out the form correctly.

How long does it take to process a DoL form?

Processing times can vary widely depending on the type of form and the current workload of the Department of Labor office handling your form. Some forms may be processed within a few weeks, while others could take several months. It's a good practice to check with the specific department or division handling your form for more accurate timelines.

Can I check the status of my DoL form submission?

Yes, in many cases, you can check the status of your submission. For online submissions, the Department of Labor typically provides a tracking feature or confirmation number that can be used to check your form's status. For mailed forms, contacting the specific department or division handling your form directly is usually the best approach to receive updates.

What should I do if my situation changes after submitting a DoL form?

If your situation changes in a way that could affect your submission, it’s important to inform the Department of Labor as soon as possible. Depending on the nature of the change and the form you submitted, you may need to provide additional information or submit a new form. Adjustments can be crucial to ensuring that your records are accurate and your rights or benefits are appropriately handled.

Common mistakes

One common mistake is inaccurately reporting employment dates. It's crucial for individuals to double-check their employment history, ensuring that the start and end dates of their previous or current employment are correctly documented. This information is key to verifying employment history and eligibility for programs or benefits.

Another area where errors frequently occur is the failure to accurately list all income sources. Individuals often overlook or mistakenly omit certain types of income, such as freelance work, part-time employment, or even unemployment benefits. This can lead to discrepancies that may require clarification, causing delays in processing the form.

A further mistake involves misunderstanding the instructions related to dependents. It's not uncommon for applicants to either underreport or overreport dependents, due to confusion about who qualifies as a dependent under the Department of Labor's criteria. Correctly identifying dependents is crucial for benefits eligibility and accurate calculation of assistance.

Incorrect social security numbers (SSNs) are also a frequent issue. The impact of transposing numbers or entering a digit incorrectly can be significant, leading to mismatches in government databases and potentially delaying the application process. It is essential for individuals to verify their SSN before submission.

Many individuals fail to sign the form or miss certain declarations that require acknowledgment. A signature and acknowledgment of all declarations are mandatory for the form to be processed. An unsigned or incomplete form is usually returned to the applicant, causing unnecessary delays.

Not attaching required documents is another error that can halt the processing of the form. Applicants sometimes miss the instructions on necessary attachments, such as proof of income, identification, or employment verification. Ensuring that all required documents are attached is vital for a smooth process.

Lastly, using outdated forms can lead to processing delays. The Department of Labor periodically updates its forms to reflect current regulations and requirements. Submitting an outdated version may result in the need to fill out a newer version, further delaying the process.

Documents used along the form

When navigating the landscape of employment documentation, especially in contexts requiring the U.S. Department of Labor (DoL) forms, there are several other key documents and forms that frequently come into play. These support various compliance and personnel management activities, helping businesses and organizations ensure they adhere to regulations and manage their workforce effectively.

  • W-4 Form - This IRS form is utilized by employees to indicate their tax withholding preferences. It helps employers withhold the correct federal income tax from workers' paychecks.
  • I-9 Form - Essential for verifying an employee's identity and eligibility to work in the United States, this document is a must-have for all employers within the country.
  • OSHA Form 300 - Required by the Occupational Safety and Health Administration, this log records work-related injuries and illnesses. It's a critical piece for maintaining compliance with safety regulations.
  • FLSA Compliance Forms - These forms help employers ensure they are adhering to the wage and hour provisions set forth by the Fair Labor Standards Act, including overtime and minimum wage rules.
  • EEO-1 Form - Used by employers to report employment data categorized by race/ethnicity, gender, and job category, this form is a key component of compliance with Equal Employment Opportunity Commission (EEOC) regulations.
  • Employee Handbook Acknowledgement Form - Though not a government-mandated document, this form is crucial as it provides evidence that employees have received and understand the policies contained within the company's handbook.
  • Benefits Enrollment Forms - These documents are used during the hiring process or designated enrollment periods for employees to select or change their benefits preferences, including health insurance, retirement plans, and more.
  • Performance Appraisal Forms - Another non-government form but essential for human resources processes, these are used to evaluate an employee's job performance, providing a basis for feedback, development, and decisions on promotions or increases in compensation.

In conclusion, the U.S. DoL form is often merely the tip of the iceberg in a sea of critical documents necessary for smooth operational, compliance, and personnel management processes. Understanding and utilizing these forms effectively is paramount for any business aiming to foster a compliant and productive workplace. By integrating these forms logically and efficiently, organizations can better navigate the intricacies of labor laws and workforce management, ensuring a solid foundation for their operations and fostering a positive work environment.

Similar forms

The U.S. Department of Labor (DoL) form shares similarities with the Equal Employment Opportunity Commission (EEOC) Charge of Discrimination form. Both documents are pivotal for employees who seek to initiate formal proceedings against their employers for violations of federal laws. Each form serves as a notification to the respective federal agency, signaling that an investigation into the alleged misconduct may be necessary. While the DoL form may deal with a broader range of employment issues, the EEOC form focuses specifically on discrimination charges. Both are critical in protecting workers’ rights and ensuring workplace fairness.

The Wage and Hour Division's (WHD) Family and Medical Leave Act (FMLA) certification forms also align closely with the U.S. DoL form in their function and importance. These FMLA forms are essential for employees requesting leave under the Act, providing a structured way to present medical or familial reasons that necessitate their absence. Similar to how DoL forms may be used to address concerns or violations related to labor standards and regulations, FMLA forms are used to ensure employees' rights to unpaid, job-protected leave for specific family and medical reasons are respected.

Occupational Safety and Health Administration (OSHA) complaint forms bear a resemblance to the DoL form. OSHA’s complaint forms are designed for reporting unsafe working conditions and health hazards in the workplace. Just as DoL forms may cover a wide range of labor issues, forms filed with OSHA are crucial for initiating investigations into workplace safety, an area under the Department of Labor's purview. Both forms play a vital role in enforcing compliance with labor laws and regulations, and in protecting employees' well-being.

The Employment Eligibility Verification Form I-9 is another document that shares attributes with the U.S. DoL form. This form is used by employers to verify an employee's eligibility to work in the United States, in compliance with the Immigration Reform and Control Act. While serving different specific purposes, both the I-9 and the DoL forms are integral to the regulatory framework governing employment in the U.S., ensuring that both labor rights and employment eligibility criteria are met.

Another document similar to the U.S. DoL form is the Internal Revenue Service (IRS) W-4 form. Though primarily focused on federal tax withholding, the W-4 form, like the DoL form, is essential for new hires and employment administration. Both forms must be completed accurately and timely to comply with U.S. laws—DoL forms for labor compliance and W-4 forms for tax purposes. Each plays a unique role in the broader context of employment and labor regulation.

The Worker Adjustment and Retraining Notification (WARN) Act notice is akin to the DoL form in its purpose to protect workers. The WARN notice must be provided by employers undergoing major layoffs or plant closures, informing workers of their rights and any impending job losses. This parallels the proactive stance of DoL forms, which seek to address and prevent violations of labor laws and to inform employees and employers of their rights and obligations under various labor standards.

Lastly, the Unemployment Insurance (UI) claim forms also share commonalities with the U.S. DoL form. UI claim forms are used by individuals who have become unemployed through no fault of their own, providing a financial safety net during periods of unemployment. Like DoL forms, which facilitate a range of employee rights and employer obligations, UI forms play a crucial role in the labor market's regulatory and support systems. Both types of forms are essential for the enforcement and administration of labor laws and protections.

Dos and Don'ts

When filling out a U.S. Department of Labor (DoL) form, it's important to approach the task with attention to detail and accuracy. This list outlines the do's and don'ts to assist in completing the form correctly and efficiently.

Do:
  1. Read the instructions carefully before beginning to ensure you understand the requirements.

  2. Use black ink or type your responses if the form permits to ensure legibility.

  3. Provide accurate information for every question, double-checking facts and figures.

  4. Sign and date the form if required, as an unsigned form may be considered invalid.

  5. Keep a copy of the completed form and any documentation submitted along with it for your records.

Don't:
  • Leave any fields blank; if a question does not apply, write “N/A” to indicate this.

  • Use correction fluid or tape; if you make a mistake, start over with a new form for a clean submission.

  • Guess on dates or figures; it's better to look up the correct information than to submit inaccuracies.

  • Ignore deadlines; submitting forms late can lead to delays or even rejection.

  • Forget to check the specific submission requirements, such as mailing address or electronic submission options.

Misconceptions

Many people hold misconceptions about U.S. Department of Labor (DoL) forms. Here are five common ones that need clarification:

  1. All DoL forms are the same.

    This is not true. The DoL provides a variety of forms, each serving different purposes. For example, the WH-380-E is used for FMLA leave related to the employee's health condition, whereas the ETA-9089 is for permanent labor certification. It's crucial to use the correct form for your specific need.

  2. You can only submit DoL forms in paper format.

    While some forms may require a paper submission, many DoL forms can be submitted online. This digital process can save time and help ensure that your form is processed more quickly. Always check the DoL website for the most current submission guidelines.

  3. Filling out a DoL form is quick and easy.

    Depending on the form, completing it can be complex and time-consuming. Some forms require detailed information and documentation. It's important to read the instructions carefully and gather all necessary information before beginning the process.

  4. Any mistake on a DoL form will lead to automatic rejection.

    While accuracy is crucial, not all mistakes will result in rejection. Minor errors might be correctable. However, significant inaccuracies or omissions can cause delays or denial of your submission. It’s best to review your form thoroughly before submitting it.

  5. The information provided in DoL forms is only reviewed by DoL employees.

    Some of the information submitted in DoL forms, especially those related to employment and labor certification, may be shared with other government agencies as part of the review and approval process. Confidentiality and privacy are maintained in accordance with federal laws and regulations.

Key takeaways

Filling out and using the U.S. Department of Labor (DoL) form correctly is crucial for ensuring compliance with federal regulations and safeguarding workers' rights. Here are key takeaways to remember:

  • Accuracy is paramount: Every piece of information entered on the form must be accurate and up-to-date. Inaccuracies can lead to processing delays, denials, or legal repercussions.
  • Follow specific instructions: The DoL form comes with detailed instructions that should be followed meticulously. These instructions are designed to prevent common mistakes and clarify what information is required.
  • Deadlines matter: There are strict deadlines for submitting the DoL form. Missing these deadlines can result in penalties, including fines or loss of certification.
  • Maintain records: After submitting the form, it's important to keep a copy for your records. Documentation may be needed for future reference, audits, or to address any discrepancies that arise.
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