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Instructions - Read Carefully
This form must be completed and returned before we can investigate your claim.
The form MUST contain the complainant's original signature. Fill it out completely and, if necessary, use a separate sheet of paper to provide additional information. Attach copies of any document which supports your claim such as, an employment contract, wage agreement, commission statements, invoices, time records, list of hours worked, check stubs, written fringe benefit (vacation pay, sick pay, holiday pay, paid time off, bonus, expense reimbursement) policy or contract. A claim form that is not filled out completely and signed will be returned.
PRINT or TYPE the information requested. Provide a phone number where you can be reached during the day.
ACCEPTANCE OF THIS CLAIM DOES NOT GUARANTEE COLLECTION
Through investigation, we will attempt to determine whether your claim is valid. Where your employer denies that wages are owed, you have the responsibility to substantiate your claim. You must also provide us with an accurate address where we may reach your employer.
Receipt of your claim will be acknowledged by a letter from this office. The investigation of your claim will be handled in the order in which it is received. When a final determination has been made, you will be
immediately notified in writing. Should you have any addition information after you have filed your claim, please do not call, mail or fax this information to the attention of the investigator assigned to your claim. Your wage claim case will remain in the open status until a final determination is made by our office. Please do not call for the status of your claim.
To file a claim you must first have asked for your wages and been denied. To maximize your chances of recovery, we suggest that you send a
CERTIFIED letter, Returned Receipt Requested, to your employer stating the amount of money you are owed, identifying the hours and days or commissions this money represents, and demanding payment by a specific deadline (such as 5 or 10 days from receipt of the certified letter). Remember to keep a copy of your letter.
There are other options available to you under Maryland law to try to collect your wages. These include bringing suit against your employer in court either by yourself or with the help of an attorney. If you succeed, the court may award you up to
3 times your wages and order the employer to pay your attorney fees. In addition, an employer's hiring of an employee with the intention not to pay wages may be a criminal offense. Employees under these particular circumstances, therefore, may have the option of filing a statement of charges with the District Court Commissioner for criminal prosecution.
NOTE: This office will not intercede in a case pending in court or where claimants are otherwise represented by legal counsel.
If your claim pertains to company paid benefits (ex.: vacation), and/or if you worked under a written contract, please attach a photocopy of all relevant documents. If documentation is not available, you must attach a complete explanation of the policy and/or contract. Please attach any other relevant documentation which could assist in proving your claim.
*There are criminal penalties for employees knowingly filing a false claim against an employer.
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