U.S. DoL Template

U.S. DoL Template

The U.S. Department of Labor (DoL) form is a crucial document used to report various employment-related information, ensuring compliance with federal labor laws. Understanding its purpose and proper completion is essential for both employers and employees to protect their rights and responsibilities in the workplace. Don’t delay—fill out the form today by clicking the button below!

Table of Contents

The U.S. Department of Labor (DoL) form serves as a crucial tool for various employment-related processes. This form encompasses a range of applications, reports, and notifications that facilitate compliance with labor laws and regulations. Employers, employees, and other stakeholders utilize the form to address issues such as wage disputes, workplace safety, and employee benefits. It plays a significant role in ensuring that workers receive fair treatment and that employers adhere to legal standards. The form may require detailed information, including the parties involved, specific claims or requests, and relevant dates. Proper completion and submission of the form can lead to timely resolutions of disputes and contribute to a more equitable workplace environment. Understanding the requirements and implications of the U.S. DoL form is essential for anyone navigating the complexities of employment law in the United States.

U.S. DoL Sample

U.S. Department of Labor Davis-Bacon and Related Acts Weekly Certified Payroll Form

Wage and Hour Division

(For Contractor’s Optional Use; See Instructions at www.dol.gov/whd/forms/wh347instr.htm)

 

Unless otherwise noted, the information requested is specific to the named project below.

 

 

Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number.

SUBMISSION OF FINAL DBRA CERTIFIED PAYROLL FORM

PRIME CONTRACTOR

SUBCONTRACTOR

Rev. January 2025

OMB No.: 1235-0008

Expires: 01/31/2028

PROJECT NAME

PROJECT NO. or CONTRACT NO.

CERTIFIED PAYROLL NO.

PRIME CONTRACTOR’S/SUBCONTRACTOR’S BUSINESS NAME

PROJECT LOCATION

WAGE DETERMINATION NO.

WEEK ENDING DATE

PRIME CONTRACTOR’S/SUBCONTRACTOR’S BUSINESS ADDRESS

(1A)

(1B)

(1C)

(1D)

(1E)

 

(2)

 

(3)

 

 

(4)

(5)

(6A)

(6B)

(6C)

(7A)

(7B)

 

 

(8)

 

 

NO.ENTRYWORKER

NAMELASTWORKER

FIRSTWORKER NAME

MIDDLEWORKER INITIAL

WORKER NO.IDENTIFYING

JOURNEYWORKER(J)

REGISTERD(RA)

APPRENTICE

LABOR CLASSIFICATION

TIMESTRAIGHT=ST

OVERTIME=OT

(TOP) DAYS OF WORK WEEK

HOURSTOTAL WEEKFORWORKED

RATEWAGEHOURLY ANDSTFORPAIDOT

FRINGETOTAL CREDITBENEFIT

LIEUINPAYMENTOF BENEFITSFRINGE

EARNEDAMTGROSS

EARNEDAMTGROSS WORKALLFOR

DEDUCTIONS FOR ALL WORK

(BOTTOM) DATES

-WITHTAX HOLDINGS

FICA

(MUSTOTHER

SEESPECIFY, INSTRUCTIONS)

TOTAL DEDUCTIONS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOURS WORKED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EACH DAY

 

 

 

 

 

 

 

 

 

 

 

(9)

FOR ALL WORK

NET PAY TO WORKER

ST

OT

ST

OT

ST

OT

ST

OT

ST

OT

ST

OT

ST

OT

ST

OT

While use of Form WH-347 itself is optional, covered contractors and subcontractors performing work on Federal or federally assisted construction contracts are required by the DBRA regulations and the contract clauses to submit payroll information on a weekly basis. The Copeland Act (40 U.S.C. § 3145) requires contractors and subcontractors performing work on Federal or federally financed construction contracts to, on a weekly basis, “furnish a statement on the wages paid each employee during the prior week.” U.S. Department of Labor (DOL) Regulations at 29 C.F.R. § 5.5(a)(3)(ii) require contractors and subcontractors to submit weekly certified payrolls to the appropriate Federal agency if the agency is a party to the contract (or, if the agency is not such a party, to the applicant, sponsor, owner, or other entity, as the case may be, that maintains such records, for transmission to the Federal agency). Each certified payroll must be accompanied by a signed “Statement of Compliance” (e.g., page 2 of the WH-347 or another document with identical wording) indicating that the certified payrolls are accurate and complete, and that each laborer or mechanic has been paid not less than the required Davis-Bacon prevailing wage rate(s) (including any fringe benefits) for the work performed. DOL and contracting agencies receiving this information review the information to determine whether workers have received legally required wages and fringe benefits.

Public Burden Statement

We estimate that it will take an average of 55 minutes to complete this collection, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of

information. If you have any comments regarding these estimates or any other aspect of this collection, including suggestions for reducing this burden, send them to the Administrator, Wage and Hour Division, U.S. Department of Labor, Room S3502,

200 Constitution Avenue, N.W. Washington, D.C. 20210

(over)

PROJECT NAME

PROJECT NO. or CONTRACT NO.

PAYROLL NO.

PRIME CONTRACTOR’S/SUBCONTRACTOR’S BUSINESS NAME

PROJECT LOCATION

 

WEEK ENDING DATE

CERTIFYING OFFICIAL’s NAME AND TITLE

I paid or supervised the payment of the laborers or mechanics working on the above project during the stated time period. I certify the following:

The payroll information submitted with this statement is correct and complete for the above project during the above period, and the wage and fringe benefit rates paid to the workers,

including credit taken for the reasonably anticipated costs of a bona fide fringe benefit plan, fund or program, are not less than the applicable wage and fringe benefits rates for the classification(s) of work actually performed, as specified in the wage determination(s) incorporated into the contract.

All regular payrolls and all other basic records that the contractor is required to maintain for this payroll period are complete and accurate and will be made available upon request from the

agency or the Department of Labor.

The classifications reported for each laborer or mechanic are the classification(s) of work that each worker actually performed.

Any workers paid as apprentices during the above period are duly registered in a bona fide apprenticeship program registered with the Office of Apprenticeship, Employment and Training

Administration, United States Department of Labor (“OA”), or a State Apprenticeship Agency (“SAA”) recognized by Department of Labor. I have verified the registered apprenticeship program information provided below as accurate and applicable to any apprentices identified on page 1 of this form.

APPRENTICESHIP PROGRAM NAME

 

REGISTERED

NAME OF LABOR CLASSIFICATION

 

 

 

OA

 

SAA

 

 

 

 

 

OA

 

SAA

 

 

 

 

 

OA

 

SAA

 

 

 

Fringe benefits have been paid in cash and/or to bona fide fringe benefit plans, funds, or programs. Where the contractor is claiming an hourly credit for their contributions to or reasonably

anticipated costs of a bona fide fringe benefit plan, fund, or program, provide plan information and the hourly credit claimed for each worker listed on the previous page of this form.

HOURLY CREDIT FOR FRINGE BENEFITS

If an amount is listed in (6B) on the first page of this certified payroll form, enter the hourly credit claimed under each plan name, type and number for each worker and check whether the plan is funded or unfunded.

 

 

 

FB NAME

 

 

 

FB NAME

 

 

 

FB NAME

 

 

 

FB NAME

 

 

 

FB NAME

 

 

 

FB NAME

 

 

 

 

TOTAL

 

 

 

FB TYPE

 

 

 

FB TYPE

 

 

 

FB TYPE

 

 

 

FB TYPE

 

 

 

FB TYPE

 

 

 

FB TYPE

 

 

 

 

NAME OF WORKER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

HOURLY

 

 

PLAN NO.

 

 

 

PLAN NO.

 

 

 

PLAN NO.

 

 

 

PLAN NO.

 

 

 

PLAN NO.

 

 

 

PLAN NO.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

CREDIT

 

Funded

Unfunded

Funded

Unfunded

Funded

Unfunded

Funded

Unfunded

Funded

Unfunded

Funded

Unfunded

 

 

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

$

 

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

$

 

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

$

 

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

$

 

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

$

 

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

$

 

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

$

 

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hourly Credit

$

Hrly Credit

$

$

All workers on the project have been paid the full weekly wages earned, and no rebates or deductions have been or will be made either directly or indirectly, other than permissible

 

deductions as defined in 29 CFR part 3.

 

 

 

 

 

 

 

 

 

 

 

ADDITIONAL REMARKS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE OF CERTIFYING OFFICIAL

 

 

DATE

 

 

TELEPHONE NUMBER

 

 

EMAIL ADDRESS

 

 

 

 

 

 

 

 

 

 

( __ __ __ ) __ __ __ – __ __ __ __

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION (SEE SECTION 1001 OF TITLE 18 AND SECTION 3729 OF TITLE 31 OF THE UNITED STATES CODE), AS WELL AS DEBARMENT FROM FUTURE FEDERAL AND FEDERALLY-ASSISTED CONTRACTS. INFORMATION REPORTED IN CERTIFIED PAYROLLS MAY BE SUBJECT TO DISCLOSURE IN RESPONSE TO A FREEDOM OF INFORMATION ACT REQUEST.

Document Attributes

Fact Name Description
Purpose The U.S. Department of Labor (DoL) forms are used for various labor-related purposes, including wage and hour claims, workplace safety, and employment statistics.
Federal Forms Some forms, like the I-9, are required at the federal level for employment verification across all states.
State-Specific Forms Many states have their own forms that comply with state labor laws. For example, California has the DLSE-1 for wage claims, governed by the California Labor Code.
Submission Methods Forms can typically be submitted online, by mail, or in person, depending on the specific requirements of the form.
Record Keeping Employers are required to keep copies of submitted forms for a certain period, often three to five years, to comply with federal regulations.
Accessibility All DoL forms are available for download on the U.S. Department of Labor website, ensuring easy access for users.
Filing Deadlines Each form may have specific deadlines for submission, which are crucial for compliance and to avoid penalties.
Confidentiality Information submitted on these forms is generally kept confidential, but certain data may be publicly available under transparency laws.
Assistance The DoL provides resources and assistance for individuals needing help with filling out forms or understanding their rights.
Updates Forms are periodically updated to reflect changes in laws or regulations, so it’s important to use the most current version.

U.S. DoL: Usage Instruction

Completing the U.S. Department of Labor (DoL) form is a straightforward process that requires careful attention to detail. Following these steps will help ensure that all necessary information is accurately provided.

  1. Obtain the correct form from the U.S. Department of Labor website or your local office.
  2. Read the instructions carefully to understand the requirements for filling out the form.
  3. Gather all necessary information, such as your personal details, employment history, and any relevant documentation.
  4. Begin filling out the form by entering your name, address, and contact information in the designated sections.
  5. Provide information about your employment, including your job title, employer's name, and dates of employment.
  6. Complete any additional sections that apply to your situation, ensuring all fields are filled out as required.
  7. Review your completed form for accuracy and completeness before submitting it.
  8. Submit the form according to the instructions, either online, by mail, or in person, as specified.

After submitting the form, you may need to follow up for any updates or further information. Be prepared to provide additional documentation if requested.

Frequently Asked Questions

  1. What is the U.S. Department of Labor (DoL) form?

    The U.S. Department of Labor (DoL) form is a document used to collect information related to various labor and employment issues. These forms may pertain to wage and hour laws, workplace safety, employee benefits, and other regulations that the DoL oversees. Depending on the specific purpose, different forms may be required.

  2. Who needs to fill out a DoL form?

    Individuals, employers, and organizations may need to complete a DoL form. For example, employees may file a form to report wage violations, while employers might need to submit forms related to employee benefits or compliance with labor laws.

  3. How do I know which DoL form to use?

    Identifying the correct DoL form depends on the issue at hand. The DoL website provides a comprehensive list of forms categorized by topic. Review the categories to find the form that aligns with your specific situation. If you are unsure, consider reaching out to a local office for guidance.

  4. Where can I obtain a DoL form?

    DoL forms can be obtained directly from the U.S. Department of Labor's official website. Most forms are available for download in PDF format. Additionally, some forms may be available at local DoL offices or through specific agencies that handle labor-related issues.

  5. Is there a fee to submit a DoL form?

    Generally, there is no fee associated with submitting a DoL form. The Department of Labor aims to provide accessible resources to ensure compliance with labor laws. However, specific circumstances or additional services may involve fees, so it is advisable to check the details for the particular form you are using.

  6. How long does it take to process a DoL form?

    The processing time for a DoL form can vary based on the type of form submitted and the volume of applications being processed. Typically, you can expect a response within a few weeks, but some cases may take longer. It is recommended to follow up if you do not receive confirmation after a reasonable period.

  7. What should I do if my DoL form is denied?

    If your DoL form is denied, you will usually receive a notice explaining the reason for the denial. Review the notice carefully to understand the issues. You may have the option to appeal the decision or provide additional information. Following the instructions provided in the notice is essential for addressing the denial.

  8. Can I get help with filling out a DoL form?

    Yes, assistance is available for completing DoL forms. Various resources can help, including the DoL website, local labor offices, and community organizations that focus on labor rights. Additionally, you may consider consulting with a legal professional if you have specific questions or need personalized guidance.

Common mistakes

Filling out the U.S. Department of Labor (DoL) form can be a straightforward process, but many individuals make common mistakes that can lead to delays or complications. One frequent error is incomplete information. People often skip sections or fail to provide necessary details, thinking they can fill them in later. However, incomplete forms can lead to processing delays or even rejections.

Another common mistake is incorrect contact information. It’s crucial to ensure that your name, address, and phone number are accurate. A simple typo can make it difficult for the DoL to reach you if they need clarification or additional information. Always double-check this information before submitting your form.

Many individuals also struggle with misunderstanding the instructions. Each form comes with specific guidelines that must be followed. Ignoring these instructions can result in errors that could have been easily avoided. Take the time to read the instructions carefully and, if needed, seek assistance to clarify any confusing points.

Another mistake people make is failing to sign and date the form. This may seem minor, but without your signature, the form is not valid. Make sure to sign and date the document in the appropriate places. A missing signature can cause unnecessary delays in processing your request.

Lastly, some individuals submit their forms without making a copy for their records. Keeping a copy of the submitted form is essential for tracking your application and for your own reference. If any issues arise, having a copy will help you address them more efficiently. Always remember to retain a copy before sending off your documents.

Documents used along the form

When dealing with U.S. Department of Labor (DoL) forms, several other documents often accompany them to ensure compliance and facilitate the process. Understanding these forms can help individuals and businesses navigate the complexities of labor regulations more effectively.

  • Employment Eligibility Verification (Form I-9): This form is used to verify the identity and employment authorization of individuals hired for employment in the United States. Employers must complete this form for each employee and retain it for their records.
  • Labor Condition Application (LCA): Required for employers seeking to hire foreign workers under certain visa categories, the LCA ensures that hiring foreign workers will not adversely affect the wages and working conditions of U.S. workers. It must be filed with the DoL before applying for a visa.
  • Fair Labor Standards Act (FLSA) Compliance Documents: These documents outline the requirements for minimum wage, overtime pay, and child labor laws. Employers must maintain accurate records to demonstrate compliance with FLSA standards.
  • Employee Handbook: While not a formal requirement, an employee handbook can serve as a crucial document that outlines workplace policies, employee rights, and responsibilities. It can help ensure that employees are informed about their rights and the company’s expectations.
  • Pay Records: Employers are required to keep detailed records of employee wages, hours worked, and other compensation-related information. These records are essential for demonstrating compliance with wage and hour laws.

By familiarizing yourself with these documents, you can better navigate the requirements set forth by the U.S. Department of Labor. Each document plays a vital role in ensuring compliance and protecting the rights of both employers and employees.

Similar forms

The U.S. Department of Labor (DoL) has various forms that serve specific purposes in the realm of employment and labor. Here are nine documents that share similarities with the DoL form:

  • Form I-9: This form is used to verify the identity and employment authorization of individuals hired for employment in the United States. Like the DoL form, it requires specific information about the employee and employer.
  • W-2 Form: Employers use this form to report wages paid to employees and the taxes withheld. Both the W-2 and DoL forms are essential for tax reporting and compliance.
  • Form 1099: This form is used to report income other than wages, salaries, and tips. Similar to the DoL form, it provides important information for tax purposes.
  • Form 941: Employers file this quarterly form to report income taxes, Social Security tax, and Medicare tax withheld from employee paychecks. Both forms help ensure compliance with federal regulations.
  • Form 5500: This document is used to report information about employee benefit plans. Like the DoL form, it is crucial for regulatory compliance and transparency.
  • Labor Condition Application (LCA): Employers seeking to hire foreign workers must file this application. It shares similarities with the DoL form in terms of ensuring fair labor practices.
  • Form ETA-9089: This form is used for permanent labor certification. Both this form and the DoL form are involved in the employment process, particularly for foreign workers.
  • Form WH-4: This form is used to claim exemption from withholding on wages. Similar to the DoL form, it pertains to wage-related issues and employee rights.
  • Form OSHA 300: This form is used to log workplace injuries and illnesses. Like the DoL form, it plays a role in ensuring a safe and compliant work environment.

Understanding these documents can help individuals navigate the complexities of employment law and ensure compliance with various regulations.

Dos and Don'ts

When filling out a U.S. Department of Labor (DoL) form, attention to detail is crucial. Here are five things you should and shouldn't do to ensure your submission is accurate and complete.

  • Do read the instructions carefully before you begin. Understanding the requirements will help you avoid mistakes.
  • Don't rush through the form. Take your time to provide accurate information.
  • Do double-check your entries for spelling and numerical accuracy. Small errors can lead to delays.
  • Don't leave any required fields blank. Incomplete forms may be rejected or returned.
  • Do keep a copy of the completed form for your records. This will be helpful for future reference.

By following these guidelines, you can streamline the process and enhance the likelihood of a successful submission.

Misconceptions

When it comes to the U.S. Department of Labor (DoL) forms, there are several misconceptions that can lead to confusion. Understanding the facts can help ensure that individuals are better prepared when dealing with these forms. Here are four common misconceptions:

  1. All DoL forms are the same.

    This is not true. The DoL has various forms tailored for different purposes, such as wage claims, workplace safety, and employee benefits. Each form serves a specific function and must be completed according to its unique requirements.

  2. You can submit DoL forms without any supporting documents.

    Many people believe they can submit a form on its own, but this is often not the case. Supporting documents, such as pay stubs or employment records, are frequently required to provide context and validate the claims being made.

  3. DoL forms can only be filed by employees.

    While employees often file these forms, employers can also submit them, especially in cases related to wage disputes or compliance issues. It’s important for both parties to understand their rights and responsibilities regarding these forms.

  4. Once a DoL form is submitted, you cannot make changes.

    This is a misconception. If you realize you need to correct or update information after submission, you can often do so. It’s best to contact the appropriate DoL office to understand the process for making changes.

Clearing up these misconceptions can help individuals navigate the requirements more effectively and ensure that they are taking the right steps in their interactions with the Department of Labor.

Key takeaways

When filling out and using the U.S. Department of Labor (DoL) form, it is important to keep several key points in mind. These takeaways can help ensure that the process goes smoothly and that you meet all necessary requirements.

  • Understand the Purpose: Each DoL form serves a specific purpose, such as reporting labor statistics, requesting benefits, or filing complaints. Knowing the purpose helps you complete it accurately.
  • Gather Necessary Information: Before starting, collect all required information, such as personal identification, employment details, and any relevant documentation.
  • Follow Instructions Carefully: Each form comes with detailed instructions. Read these carefully to avoid mistakes that could delay processing.
  • Be Honest and Accurate: Provide truthful and precise information. Inaccuracies can lead to legal consequences or denial of benefits.
  • Review Before Submission: Double-check all entries for errors or omissions. A thorough review can prevent unnecessary complications.
  • Keep Copies: Always retain a copy of the completed form and any supporting documents for your records. This can be useful for future reference.
  • Know the Submission Methods: Familiarize yourself with how to submit the form—whether online, by mail, or in person. Each method may have different requirements.
  • Follow Up: After submitting the form, monitor the status. If you do not receive confirmation or updates in a reasonable time, consider following up with the relevant department.