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Get SD Claim of Unpaid Wages 2016-2021

days were in your pay period? What was the last day of your pay period? What was your payday? If you are a member of a labor union, provide the name and address of local, national, or international union. Page 2 | CLAIM OF UNPAID WAGES use additional pages if necessary Rev. 12/2016 Are you still working for this Employer? If No, reason why: Yes No Quit? Terminated? Laid Off? Explain: WAGES CLAIMED Total dollar amount you are claiming (Use the attached Wages Claimed Schedule): Gross.

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