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Please read the following information carefully before submitting a complaint form to the Wage and Workplace Standards Division

The Wage and Workplace Standards Division can only investigate alleged violations of labor laws under its jurisdiction in an employer-employee relationship.  

We do not cover certain issues such as, but not limited to, wrongful termination, unemployment related matters, employment discrimination, business expenses, and tax issues. We can only investigate complaints for wages within two years of the filing DATE of a complaint with the Division. WE CANNOT ACCEPT ANONYMOUS COMPLAINTS.

For specific laws we do cover, please refer to our complaint forms and our website. 

If you need to file a wage complaint with our Wage and Workplace Standards Division, you may access the Statement of Claim for Wages Form through our Web site. This form was previously available only through the mail or by visiting your local American Job Center. The Wage Payment Laws are available on our web site for your convenience. 

Please note that because the form requires your signature, it is not a form that you can transmit electronically to our department. In order to use the form, you must print it. However, we now have two versions of the form available to you: one version that requires you to produce a paper copy, and print or type the information requested, and one version that allows you to complete the form on-line. 

Special Instructions When Completing the On-Line version of the Statement of Claim for Wages Form: 

The on-line version of this form was designed in PDF format to enable you to complete it on your computer. However, in order for you to view and print PDF files, it is necessary to have the Adobe Acrobat Reader software installed on your computer. The Adobe Acrobat Reader may be downloaded for free from the Adobe Web Site.  

Do not attempt to save your completed form to your computer unless you have the full version of the Adobe Acrobat software installed on your computer. Trying to do so will cause you to lose all the information you entered. 

Regardless of which version of the form you choose, make sure that once you print it out, that you sign the form, and return it to the address provided at the end of the form. 

If you need assistance in completing this form, please contact the Wage and Workplace Standards Division at (860) 263-6790 or your local Connecticut Works Career Center.

The following is a list of all Wage and Workplace Standards Wage Complaint Forms:

Click here for a complete list of all Wage and Workplace Standards Division Complaint Forms


200 Folly Brook Boulevard, Wethersfield, CT 06109 / Phone: 860-263-6000

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