Submit form LS223 to make a claim regarding unpaid wages, unpaid wage supplements, minimum wage or overtime violations, illegal deductions. If you have questions about how to complete this form call (888) 469-7365.You will be directed to the nearest WHD office for assistance. Please explain your complaint including the details such as date, time and location. Describe the events in the order in which they happened. File Workplace Complaint. Please provide your full name. Complaints sent using "Anonymous" as a name and address or using a false phone number will not be processed. Enter information relating to the involved Minor(s) (under the age of 18) in the area provided below. Failure to complete the form in its entirety will delay the complaint process.