Wage & Hour Forms

Child Labor

Age Certificate (16 or 17 year old)

Supervision Permit Form

Work Based Learning Permit / WECEP Work Permit - Only for School Administered Work Experience & Career Programs for 14 & 15 year old. If needed, please contact Wage & Hour at (304) 558-7890 ext. 10474.

Work Permit (14 or 15 year old)

Wage Bond

Bonds

Certificate of Deposit (CD)

Letter of Credit Form - From used by financial institutions to issue a letter of credit.

Request to Invest Form (Cash Bond) - Required when posting a cash bond with the Consolidated Investment Fund.

     Employer's Authorization To Draw Upon the Cash Bond (Cash Bond)

     W-9 Form (Cash Bond)

Surety Form (Inc., LLC or other business entity) - Form used by insurance companies to write a wage bond.

Surety Form (Sole Proprietor or Partner) - Form used by insurance companies to write a wage bond.

Affidavits

Wage Bond Cancellation Affidavit (For Surety Bonds Only)

Wage Bond Owner / Officer Affidavit (For Companies)

Wage Bond Release Affidavit (For Companies)

Wage Bond Status Affidavit (Must Always Be Filled Out)

Wage Collection

Employees

RFA Online Submission

RFA Form

Wage Assignment Form

Wage Assignment Information Sheet

Employers

Wage Assignment Form

Wage Assignment Information Sheet

1900 Kanawha Boulevard East | State Capitol Complex - Building 3, Room 200 | Charleston, WV 25305
Ph: (304) 558-7890

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