This form is intended to assist the attorney in case preparation by providing the client with a form to be used in documenting all expenses and lost wages associated with the client's claim.
Florida Wage and Income Loss Statement
State:
Multi-State
Control #:
US-PI-0009
Format:
Word;
Rich Text
Instant download
Description
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How to fill out Wage And Income Loss Statement?
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FAQ
Under Florida law, an employee may bring a civil theft claim against an employer when the employer has not paid wages due. Before filing an action in court, the employee must provide the employer with written notice of the claim and allow the employer 30 days to pay the amount due.
You may register a complaint with the DOL in two ways. You may locate the nearest DOL office by visiting their website or start your claim by phoning 1-866-4USWAGE.
Submit a Wage Theft Complaint Affidavit form by email, mail or fax. Include copies of any documents that show you were an employee of the business and support your claim, such as paycheck stubs, W-2's, cancelled paychecks, timesheets, time cards/slips and employment agreements/contracts.
Use the 13 calendar weeks immediately preceding the week of the accident and start with the most recent full calendar week before the week of the accident. For example, if the accident occurred on a Wednesday, then week No. 1 should begin the preceding Sunday and end the preceding Saturday.
File a lawsuit for civil theft. Under Florida law, an employee may bring a civil theft claim against an employer when the employer has not paid wages due. Before filing an action in court, the employee must provide the employer with written notice of the claim and allow the employer 30 days to pay the amount due.
If an employer is found to have unlawfully failed to pay earned wages, the employee will be entitled to receive three times the amount of back wages that the employer is found to have unlawfully failed to pay the employee.
What Can You Do to Fight Wage Theft? Learn about your rights. If you are a victim of wage theft, take action: File a wage claim against your employer. The Labor Commissioner's Office can order your employer to pay you the wages and penalties you are owed. Report widespread cases of wage theft to our investigators.
As an injured worker, you may be entitled to receive lost wage payments to help offset reduced income while on ?no work? or ?light duty? status as a result of a workplace accident. The amount you are due is controlled by Section 440.14 of the Florida Statutes and is based on your Average Weekly Wage (AWW).