Minimum Wage Complaint/Declaration Form

Complaints must be initiated by submitting a completed Claim Declaration on the form provided by the City. Copies of the Claim Declaration form are available from the City via email or U.S. mail request; by clicking the link below, or from City Hall at 211 West Aspen Avenue, Flagstaff during regular business hours. Email requests for a Claim Declaration form should be directed to:

Completed Claim Declaration forms may be mailed or submitted in person to the City Hall address above or submitted via email to: Anonymous complaints will not be investigated by the Office of Labor Standards.

Supporting documents related to the complaint should accompany the Claim Declaration form. For example: claims regarding wage issues should provide pay stubs; claims regarding failure of Employer to post notice of rights may include photos; claims regarding retaliation may include emails from Employers and/or contacts of those who may be witnesses.

The Office of Labor Standards will review the complaint to determine whether there is sufficient evidence supporting the initial claim and, if so, shall investigate the claim.

Retaliation Prohibited

Please note that an employer may not retaliate against an employee, and it is unlawful to take adverse action against an employee who asserts his/her rights to receive Flagstaff’s minimum wage, or for assisting any other person in doing so, or for informing any person about their rights. Retaliation may include, but is not limited to, termination, demotion, reduction in hours or pay, discouraging complaints regarding noncompliance with the minimum wage law, reducing vacation/PTO hours or other non-wage benefits, increasing expenses for employees for items such as parking, meals, and/or uniforms.

Minimum Wage Complaint/Declaration Form