Living Wage Complaint Form (PDF) - Broward County 2025

1. Click ‘Get Form’ to open the Living Wage Complaint Form in the editor.
2. Begin by entering your personal information, including your last name, first name, middle initial, and contact numbers. Ensure that your home address is complete with city, state, and zip code.
3. Next, provide details about the Contract Administrator. Indicate whether you have contacted them and include their address if applicable.
4. Fill in the company details where you believe a violation occurred. Include the company name, supervisor's name and position, and any previous complaints made to your supervisor.
5. Detail the nature of the complaint by describing what occurred under the specified Broward County Contract. Be thorough in your narrative.
6. Indicate if there is evidence or documentation available for review. If so, describe it clearly.
7. If there are witnesses to the incident, provide their names and contact information as required.
8. Finally, sign and date the form to declare that all information provided is true and correct before submitting it along with any payroll documentation.

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