Form SFN52114 "Complaint Inquiry" - North Dakota

What Is Form SFN52114?

This is a legal form that was released by the North Dakota Department of Labor and Human Rights - a government authority operating within North Dakota. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2020;
  • The latest edition provided by the North Dakota Department of Labor and Human Rights;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form SFN52114 by clicking the link below or browse more documents and templates provided by the North Dakota Department of Labor and Human Rights.

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Download Form SFN52114 "Complaint Inquiry" - North Dakota

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COMPLAINT INQUIRY
600 E Boulevard Ave Dept 406
Bismarck ND 58505-0340
NORTH DAKOTA DEPARTMENT OF LABOR AND HUMAN RIGHTS
701-328-2660
Fax 701-328-2031
SFN 52114 (7-2020)
ND Toll-Free 1-800-582-8032
TTY: 1-800-366-6888
www.nd.gov/labor
labor@nd.gov
ALL BLANKS MUST BE COMPLETED
COMPLAINANT INFORMATION
Name
Do you want to remain anonymous if possible?
Yes
No
Mailing Address
City
State
ZIP Code
Email Address
Do you consent to receiving correspondence exclusively at this email address?
Yes
No
Telephone Number
Signature
Home
Work
Cell
EMPLOYER INFORMATION
Owner/Manager Name
Employee/Company Name
Mailing Address
City
State
ZIP Code
Email Address
Telephone Number
Person to Contact (if different from owner/manager)
Describe the Situation: (Be as specific as possible-include names, dates, places, etc.) (For final paycheck, please include: hourly rate,
hours worked, and dates worked)
NOTICE - Anything you submit to us in a paper form will be scanned to an electronic version and the original destroyed.
COMPLAINT INQUIRY
600 E Boulevard Ave Dept 406
Bismarck ND 58505-0340
NORTH DAKOTA DEPARTMENT OF LABOR AND HUMAN RIGHTS
701-328-2660
Fax 701-328-2031
SFN 52114 (7-2020)
ND Toll-Free 1-800-582-8032
TTY: 1-800-366-6888
www.nd.gov/labor
labor@nd.gov
ALL BLANKS MUST BE COMPLETED
COMPLAINANT INFORMATION
Name
Do you want to remain anonymous if possible?
Yes
No
Mailing Address
City
State
ZIP Code
Email Address
Do you consent to receiving correspondence exclusively at this email address?
Yes
No
Telephone Number
Signature
Home
Work
Cell
EMPLOYER INFORMATION
Owner/Manager Name
Employee/Company Name
Mailing Address
City
State
ZIP Code
Email Address
Telephone Number
Person to Contact (if different from owner/manager)
Describe the Situation: (Be as specific as possible-include names, dates, places, etc.) (For final paycheck, please include: hourly rate,
hours worked, and dates worked)
NOTICE - Anything you submit to us in a paper form will be scanned to an electronic version and the original destroyed.