The following information is required to process this Wage Claim:
- Employee and Employer name, mailing address and telephone number.
- The gross amount of claim.
- Length of employment – include dates.
- Type of claim (e.g. non-payment, overtime, deduction, etc.).
- Dates and hours worked if claiming non-payment of wages (see examples below).
- Signature and date.
Denial of Claim
This claim will not be processed if:
- The amount claimed represents payment for time not actually worked (examples: holiday pay, sick pay, reimbursements, severance pay, overdraft fees or bonus pay).
- Your former employer has filed for bankruptcy protection. You should contact the bankruptcy court.
- The employer does not have a location in Indiana.
- You worked as an independent contractor. You should consult an attorney.
- You initiated private legal action to recover the wages claimed.
- You were employed by the State of Indiana (Please contact the Indiana State Personnel Department).
- The claim is against a business in which you were an owner or partner.
Please be patient, as it can take as long as 90 days to resolve some wage disputes.
If your wage claim is accepted, correspondence will be sent directly to the employer. The employer will have two (2) weeks to either mail a check directly to you or dispute the amount claimed. If no response is received, a final notice will be sent to the employer allowing one (1) additional week for response. If no response is received after the final notice, a copy of the Wage Claim file will be sent to you along with a letter recommending that you consult an attorney or pursue your claim in the appropriate court. If the employer disputes the amount claimed, the Indiana Department of Labor will make a determination based upon Indiana law and all evidence presented. If a determination cannot be made, you will receive notice along with a letter recommending you consult an attorney or pursue your claim in the appropriate court.
Examples of Wage Calculations
Examples of Mathematical Calculations of the Amount of Claim (Your calculations must match the amount of claim):
NON-PAYMENT OF PAYCHECK
|Date||Hours Worked||Wage Rate||Amount Owed|
|8/6/19||10.50 Hours||x||$12.00||=||+ $126.00|
Total Amount Due
NON-PAYMENT OF VACATION
|# Hours of Accrued Vacation Time||Wage Rate||Amount Claimed|
|Pay Date||Amount Deducted||Amount of Claim|
Total Amount Due