Wage & Hour Forms

Child Labor

Age Certificate (16 or 17 year old)

Blanket Work Permit

Supervision Permit Form

Work Permit (14 or 15 year old)

Wage Bond

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.

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 Payment & Collection

  Employees

RFA Online Submission

RFA Form

Wage Assignment Form

Wage Assignment Information Sheet

  Employers

Wage Assignment Form

Wage Assignment Information Sheet

  State Government Employer

WV State Government Employee Wage Assignment

  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