How To Fill Out The Labor Board Initial Report
The Initial Report or Claim is the document which initiates the case with the Labor Commissioner’s Office. You may download the Initial Report or Claim here: https://www.dir.ca.gov/dlse/forms/wage/english.pdf, or pick up a copy from your local Labor Commissioner’s Office.
You want to try to provide as much information as possible that is being requested, and to the best of your ability. As an example, if you do know the exact date of your termination or the exact date range of when you were employed by the company, you should still fill in your closest approximation to those dates. If a certain section does not apply to you, feel free to write into that section “Not Applicable” or “N/A”. Below is a brief description of some of the unique inquiries on the Initial Report or Claim.
Did you keep a record of hours worked?
This question is asking whether you or your employer had maintained any time keeping records. Typically, the answer would be yes if your employer had an electronic clock in/clock out system, or a written timesheet or other time keeping practice. This could also be a journal kept by you or a phone application, or copies of a work schedule.
Total Hours Worked
You should provide your regularly scheduled hours worked for the company, not the amount of hours you were not paid (i.e. If you worked 50 hours per week and were only paid for 40 hours, then you should state that you worked 50 hours per week (not that you had 10 hours of unpaid wages per week).
Rate of Pay
You should input the hourly rate or other compensation that you believe you were supposed to be paid, not what you were actually paid. If your rate of pay changed and you are demanding unpaid wages that would impact multiple rates of pay, then include each of them and the time periods in which you were paid each rate of pay. Include any and all additional pay, such as bonuses, commissions, etc.
Brief Explanation of Issues
You should enumerate the various claims you are making, such as the wages and penalties you allege that you are owed. You may attach an additional sheet of typed or handwritten paper if you do not have enough space on the Initial Report or Claim. For penalties, make sure to include waiting time penalties. You may arguably attempt to also claim wage statement penalties. For more information on wage statement penalties, see Labor Code Section 226.
This is the total amount of unpaid wages you are asserting that you are owed. Arguably, this section may not include waiting time or wage statement penalties.
Were you Paid at the Time of Discharge
This question is asking you if you were provided a final paycheck at the time your employment ended. Responding to this question and relating questions on the Initial Report or Claim requires an understanding of Labor Code Sections 201-203. Pursuant to Labor Code Sections 201-203, all final wages are due to an employee immediately upon termination (Labor Code section 201), or if the employee gives you more than 72 hours notice of the resignation, then their final wages are due at the time of quitting, i.e. last day worked. This includes any accrued and unused vacation time (i.e. “waiting time penalties”). If you quit and did not provide an employer with 72 hours notice, then they have 72 hours to provide you with final pay. If an employer does not comply with the foregoing, then you are likely owed 30 days of additional pay (i.e. waiting time penalties). It is noteworthy to mention that if you are claiming any unpaid wages, then the employer by default has not provided you with a final paycheck which included all wages due and owing at the time your employment ended. Therefore, you should fill this in as “No.”
If you are not an English speaker, or you are only conversational in English and fluent in another language, then it is advised that you check this off and fill in the first language that you are fluent in. The Labor Board generally will coordinate to have an interpreter in your fluent language available during the informal meeting and/or hearing.