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Forms
The following forms may be necessary for compliance with Suffolk County's Living Wage Law. To download, click the file name. Adobe Acrobat Reader is necessary for viewing and printing of these forms.
LW1-Notice of Application for County Assistance
LW2-Certification of Compliance
Replaced by LW38
LW3-Certification of Non-Applicability
Replaced by LW38
LW4-Request for General Living Wage Exemption
LW5-Request for Specific Living Wage Exemption
LW6-Notice of Incomplete Submission
LW7-Notice of Coverage by Living Wage Rules
LW8-Covered Employee Complaint Form
LW9-Notice of Appeal
LW10-Grant of Exemption of Living Wage Requirements
LW11-Denial of Exemption of Living Wage Requirements
LW12-Determination of Non-Compliance with Living Wage Regulations
LW13-Notice of Applicability of Living Wage Law
LW29-Application for Hardship Assistance
LW30-Hardship Assistance Authorization
LW31-Notice of Decision/Hardship
LW32-Payroll Record
LW33-Declaration of Compliance
Replaced by LW38
LW35-Notification of Rights
LW38-Certification/Declaration
Replaces forms LW2, LW3, and LW33.
LW39-Application for Hardship Assistance
LW40-Hardship Award Reconciliation Report
LW42-Volunteer Not-For-Profit Paperwork Reduction Requirements
LW44-Not For Profit Requirements
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