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Pw 12 2026
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- Click ‘Get Form’ to open it in the editor.
- Begin by entering the employer information. Fill in the name, DBA name(s), FEIN (if applicable), physical address, mailing address, and phone number.
- Indicate when the notice was given by selecting either 'At hiring' or 'Before a change in pay rate(s)'.
- Fill out the employee’s rate(s) of pay for each type of work or shift. Enter the hourly rates and specify the corresponding work types.
- If applicable, list any allowances taken such as tips, meals, lodging, or other. Specify amounts where necessary.
- Specify the regular payday and select how often pay is issued: weekly, bi-weekly, or other.
- Detail the overtime pay rates for each type of work or shift as required by law.
- Finally, have the employee acknowledge receipt of this notice by printing their name, signing, and dating the form.
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To be used by any interested person or employee organization to file a complaint alleging the underpayment of prevailing wages or supplements on a public workRead more
PW -12 (1 -09) OF EMPLOYEE. THIS CERTIFICATION MUST BE COMPLETED ON EACH WEEKLY PAYROLL FORM USED BY THE CONTRACTOR OR SUBCONTRACTOR. BENEFITS ARE PAID IN CASH