Images for is itOFFICE OF THE ATTORNEY GENERAL LETITIA JAMES STATE OF NEW YORK DEPARTMENT OF LAWCOMPLAINT FORMLABOR BUREAU28 Liberty Street, 15th Floor, New York, NY 10005Tel. (212) 4168700Fax (212) 4168694EMPLOYEE/COMPLAINANT YOUR NAMEDAYTIME PHONE 2026

1. Click 'Get Form' to open it in the editor.
2. Begin by entering your name in the 'EMPLOYEE/COMPLAINANT YOUR NAME' field. Ensure that your full legal name is provided for accurate processing.
3. Fill in your daytime phone number, street address, and home phone number. This information is crucial for communication regarding your complaint.
4. Indicate the best time to reach you by phone, along with your city, state, and ZIP code. This helps facilitate timely responses from the Labor Bureau.
5. Provide details about your employer, including their name, telephone number, and address. Specify how many people work for this employer at all locations.
6. Complete the section regarding your job title, employment dates, hours worked, and pay rate. Be sure to check if you receive a meal break and indicate your payment frequency.
7. In the 'YOUR COMPLAINT' section, clearly describe the nature of your complaint. Include any relevant details about other employees involved.
8. Finally, review all entered information for accuracy before signing and dating the form at the bottom.

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