Department of Labor Forms and Instructions

The North Dakota Department of Labor utilizes a number of forms to gather information relating to potential violations of labor or human rights laws.

Instructions for accessing the forms on this page

• Users of Adobe 6.0 and above who wish to use the tab key to move through the form during completion (instead of clicking in each field) will need to change a setting before completing the form so that the tabbing order works correctly. Open Adobe Acrobat, go to the tab in the top labeled Edit, go to Preferences, and Accessibility. Make sure the box for Use Document Structure for Tab Order when No Explicit Tab Order is Specified is not checked.
  
  
• In order to avoid additional white space added to the margins of your printed form, Page Scaling should be set to None. This setting can be changed by going to File, then Print. There you will find a Page Handling section. In the Page Scaling area of this section, select None from the drop down options. If any other options are selected, additional white space will be added to the margins and the content of the form will shrink accordingly.

Employment and Age Certificate (State Form 4598 - 75 kb pdf)
[Form 4598] [4598 Instructions]

Claim for Wages (State Form 17081 fillable - 60 kb pdf)
[Form 17081] [Preliminary Procedures] [17081 Instructions]

Complaint Inquiry (State Form 52114 fillable - 65 kb pdf)
[Form 52114] [52114 Instructions]

Employment Discrimination Questionnaire/Affidavit (State Form 14543 fillable - 161 kb pdf)
[Form 14543] [14543 Instructions]

Employment Retaliation (Whistleblower) Questionnaire/Affidavit (State Form 54049 fillable - 74 kb pdf)
[Form 54049] [54049 Instructions]

Housing Discrimination Intake Questionnaire (State Form 52229 fillable - 135 kb pdf)
[Form 52229] [52229 Instructions]

Human Rights Discrimination Intake Questionnaire (State Form 52974 fillable - 106 kb pdf)
[Form 52974] [52974 Instructions]

Independent Contractor Verification Application (State Form 58394 fillable - 773 kb pdf)
[Form 58394] [58394 Instructions]

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