The WH-58 form is a document issued by the U.S. Wage and Hour Division of the Department of Labor, used to acknowledge the receipt of back wages or other compensation owed to an employee. This form ensures that employees are informed about their rights under various labor laws, including the Fair Labor Standards Act and the Family and Medical Leave Act. By signing the WH-58, employees confirm that they have received the specified payment and understand the implications of accepting it.
The WH-58 form, issued by the U.S. Wage and Hour Division of the Department of Labor, serves as an important document for employees who have received back wages or other compensation due to them. This form is typically utilized after an investigation by the Wage and Hour Division, which assesses compliance with various labor laws, including the Fair Labor Standards Act and the Family and Medical Leave Act. The form requires specific information, such as the employee's name, the employer's details, and the time period for which the compensation is owed. It also outlines the gross amount of back wages received, any legal deductions, and the net amount that the employee ultimately receives. Notably, the WH-58 includes a critical notice informing employees that by accepting the payment, they waive their right to pursue further legal action for unpaid wages related to the specified time frame. Additionally, the form must be certified by the employer, confirming that the payment has been made in full. It is essential for both employees and employers to understand the implications of this form, as it carries legal weight and can affect the rights of the employee regarding future claims for unpaid wages.
What is the purpose of the WH-58 form?
The WH-58 form is used to document the payment of back wages, employment benefits, or other compensation owed to an employee. This form is issued by the U.S. Wage and Hour Division of the Department of Labor following an investigation. It ensures that employees receive the compensation they are entitled to under various labor laws, including the Fair Labor Standards Act and the Family and Medical Leave Act. The form provides a record of the amount paid and serves as an acknowledgment of receipt by the employee.
What should I do if I disagree with the amount listed on the WH-58 form?
If you believe that the amount listed on the WH-58 form is incorrect, it is important to address the issue promptly. First, review the details of the payment and the period covered. You may want to gather any relevant documentation, such as pay stubs or employment records. After that, contact the employer or the Wage and Hour Division to discuss your concerns. It is crucial to resolve any discrepancies before signing the form, as acceptance of the payment may limit your ability to pursue further claims.
What happens if I sign the WH-58 form?
By signing the WH-58 form, you are acknowledging that you have received the payment specified. This acceptance means that you may be giving up your right to sue for unpaid wages or overtime compensation for the time period indicated on the form. It is essential to understand that this acceptance includes any potential claims for liquidated damages, attorney's fees, and court costs related to the unpaid wages. Therefore, review the form carefully before signing to ensure that you fully understand the implications.
Is there a time limit for claiming back wages?
Yes, there is a time limit for claiming back wages under the Fair Labor Standards Act. Generally, a two-year statute of limitations applies. This means that if you believe you are owed wages for a specific period, you should act within two years from the date the wages were due. If you miss this deadline, you may lose your right to recover those wages. It is advisable to seek assistance as soon as possible if you think you have a claim.
Ensure accurate information is provided on the WH-58 form, including your name, employer's name, and payment details.
The form is used to acknowledge receipt of back wages, employment benefits, or other compensation from your employer.
Understand that signing the WH-58 form means you are giving up your right to sue for unpaid wages or overtime for the specified period.
Review the payment amount carefully before signing. Confirm that it matches what you believe you are owed.
Be aware of the relevant laws indicated on the form, such as the Fair Labor Standards Act and the Family and Medical Leave Act.
Note that the acceptance of payment typically includes a two-year statute of limitations for recovering back wages.
Do not sign the form unless you have physically received the payment stated.
The employer must certify that the payment has been made in full before you sign the form.
Understand the penalties for providing false information on the form, which can include fines or imprisonment.
Understanding the WH-58 form can be challenging, and several misconceptions may arise. Here are six common misunderstandings about this important document:
This is not true. The WH-58 form can be used by employees of any size employer who has been involved in a Wage and Hour Division investigation, regardless of the company's size.
While signing the form does mean you accept the payment listed, it does not prevent you from pursuing other claims if they are unrelated to the payment you received.
The amount shown may not reflect all wages owed. It represents the payment calculated by the Wage and Hour Division, which may differ from what you believe you are owed.
This form also covers employment benefits and other compensation, not just wages. It addresses a variety of compensation types that may be owed to an employee.
You have the right to question the accuracy of the payment. If you believe there is an error, you can contact the Wage and Hour Division for clarification.
While it is an important document, signing the WH-58 form does not create a legally binding contract in the traditional sense. It acknowledges receipt of payment, but it does not waive all rights related to future claims.
3NHD
U.S. Wage and Hour Division
Receipt for Payment of Back Wages,
U.S. Department of Labor
Employment Benefits, or Other Compensation
Wage and Hour Division
I, _________________Lawrence,_ Kevin
have received payment of wages, employment benefits,
(typed or printed name ofemployee)
or other compensation due to me from Lockheed Martin Corporation, 599 Tomales Road, Petaluma,
(name and location ofthe establishment)
for the period beginning with the workweek ending
05/07/2011______________ through the workweek
ending
03/10/2012
, The amount of the payment I received is shown below.
This payment of wages and other compensation was calculated or approved by the Wage and Hour Division and is based on the findings of a Wage and Hour Division investigation. This payment is required by the Act(s) indicated below in the marked box(es):
П Fair Labor Standards Act1
0 Service Contract Act
Family and Medical Leave Act
О Davis-Bacon and Related Act(s)
Employee Polygraph Protection Act
Other
Migrant and Seasonal Agricultural Worker Protection Act
Contract Work Hours and Safety Standards Act
Gross Amount Back Wages $0,555.13
Legal Deductions
Other Amount Paid
(please specify type)
Net Amount Received
‘NOTICE TO EMPLOYEE UNDER THE FAIR LABOR STANDARDS ACT (FLSA) - Your acceptance of this payment of wages and other compensation due under the FLSA based on the findings of the Wage and Hour Division means that you have given up the right you have to bring suit on your own behalf for the payment of such unpaid minimum wages or unpaid overtime compensation for the period of time indicated above and an equal amount in liquidated damages, plus attorney's fees and court costs under Section 16(b) of the FLSA. Generally, a 2-year statute of limitations applies to the recovery of back wages. Do not sign this receipt unless you have actually received this payment in the amount indicated above of the wages and other compensation due you.
Signature of employee
Date
Address
EMPLOYER’S CERTIFICATION TO WAGE AND HOUR DIVISION OF THE
DEPARTMENT OF LABOR:
I hereby certify that I have on this (Date)
paid the above-named
employee in full covering lost or denied wages or other compensation as stated above.
SignatureTitle
(Employer or authorized representative)
PENALTIES INCLUDING FINES OR IMPRISONMENT ARE PRESCRIBED FOR A FALSE
STATEMENT OR MISREPRESENTATION UNDER U.S. CODE, TITLE 18, SEC. 1001
1. WAGE AND HOUR COPY
Form WH-58 (Rev. September 2010)
Date: 10/05/2012 9:28:30 AM
Case ID: 1623334
Page 1
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Incorrectly filling in personal information: Many individuals fail to provide accurate details such as their full name, address, or the correct dates of the work period. This can lead to delays or complications in processing the form.
Neglecting to specify payment details: Some people overlook the section where they need to indicate the gross amount of back wages, legal deductions, and net amount received. Incomplete financial information can result in misunderstandings regarding the payment amount.
Failing to sign the form: A common mistake is submitting the form without a signature. This omission invalidates the form and may prevent the employee from receiving their entitled compensation.
Not understanding the implications of acceptance: Employees often do not fully grasp that signing the form means they relinquish their right to sue for unpaid wages or overtime. This lack of understanding can lead to unintended consequences.
When filling out the WH-58 form, it is important to be thorough and accurate. Here are four things you should and shouldn't do:
The WH-58 form, which documents the payment of wages and other compensation, shares similarities with the IRS Form W-2. The W-2 is issued by employers to report an employee's annual wages and the taxes withheld from their paycheck. Both forms serve as official records of compensation, but while the WH-58 focuses on a specific payment related to wage recovery, the W-2 summarizes an entire year's worth of earnings and tax information. Each document plays a crucial role in ensuring transparency and accountability in employment practices, allowing employees to understand their compensation and tax obligations.
Another document akin to the WH-58 is the Wage and Hour Division's WH-150, which is used for claims related to unpaid wages. The WH-150 allows employees to formally request a review of their wage claims and serves as a basis for the Department of Labor to investigate potential violations of wage laws. Like the WH-58, it emphasizes the importance of proper wage payment and provides a structured process for addressing grievances. Both documents reinforce employees' rights and the obligations of employers under the Fair Labor Standards Act.
The WH-58 also bears resemblance to the Employee's Claim for Unemployment Benefits, often referred to as the UI Claim form. This document is used by individuals seeking financial assistance after losing their job. Both forms are essential for employees seeking compensation, but while the WH-58 pertains to back wages and compensation due from an employer, the UI Claim form focuses on benefits available during periods of unemployment. Each form underscores the importance of ensuring that employees receive the financial support they are entitled to, whether through wages or unemployment benefits.
Additionally, the WH-58 can be compared to the FMLA Certification of Health Care Provider form. This document is used when an employee requests leave under the Family and Medical Leave Act (FMLA) due to a serious health condition. Both forms are tied to employee rights and protections, ensuring that individuals receive the benefits they are entitled to under federal law. While the WH-58 deals with compensation for work performed, the FMLA form addresses the need for job-protected leave, highlighting the balance between work obligations and personal health needs.
Another similar document is the Fair Labor Standards Act (FLSA) Fact Sheet. This document provides an overview of employee rights and employer responsibilities under the FLSA, including information about minimum wage and overtime pay. While the WH-58 serves as a receipt for specific wage payments, the FLSA Fact Sheet educates employees about their rights and the legal framework governing wage and hour laws. Both documents aim to empower employees by providing clarity on their rights and the mechanisms available for addressing wage-related issues.
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Lastly, the WH-58 is comparable to the Wage Theft Complaint form. This form is utilized by employees to report instances of wage theft, where they believe they have not been compensated fairly for their work. Similar to the WH-58, which documents wage payments, the Wage Theft Complaint form initiates an investigation into potential violations of wage laws. Both forms serve as tools for employees to advocate for their rights and seek recourse when they believe their compensation has been mishandled or denied.