W&H Forms

Child Labor​​

Age Certificate (16 or 17 year old)

Blanket Work Permit

Supervision Permit Form

Work Permit (14 or 15 year old)

Polygraph Examiner

Polygraph Examiner Forms

Wage ​Bond 


Certificate of Deposit​ (CD)

Letter of Credit Form - Form 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.

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)

Wa​​ge​ Payment​​ & Colle​​cti​​​​on

Employees​​

Request For Assistance Form  (This is not a Request for Investigation)

Wage Assignment Form (Notarization is a suggestion, not a Requirement)

Wage Assignment Information Sheet

​Employers

Wage Assignment Form (Notarization is a suggestion, not a Requirement)

Wage Assignment Information Sheet

State ​​Government Employer

WV State Government Employee Wage Assignment Form (Notarization is a suggestion, not a Requirement)

Jobs ​​Act​

Jobs Act ​Weekly Payroll Form

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