If you have questions about how to complete this form call (888) 469-7365. Submit form LS223 to make a claim regarding unpaid wages, unpaid wage supplements, minimum wage or overtime violations, illegal deductions.Gather information you will need to file your complaint. You may submit your complaint online or visit a Department of Labor office to submit a complaint in person. To file a complaint or to request a referral, please fill out this form and an OLPS representative will contact you. PRINT COMPLAINT FORM: A complaint form can be printed and completed for mail or email submission OR call to request one be sent to you. If your complaint is about a place that the PDA checks, or if you're not sure who checks it, you can fill out a Food Safety Complaint Form online. Please fill out the form below, but READ THIS FIRST. Employment Information. The Department of Labor processes the following types of employment-related complaints.