To mail, print and complete this form and send to:

Division of Labor Standards

Attn: Prevailing Wage Program

P.O. Box 449, Jefferson City, MO 65102-0449

Phone: 573-751-3403 Fax: 573-751-3721


When using this form, please use one of the following web browsers: Microsoft Edge, Google Chrome, or Mozilla Firefox.

Complainant Information
* The "Asterisk" Denotes Required Field



~ Please provide email address for confirmation and correspondence about this complaint.

Type of Complaint
Project Identification - Complaint Against

Time employed on this project
Type of Project
Pursuant to RSMo. 290.290 MODLS can only pursue administrative action for one (1) year from final project payout.
Complaint Summary & Supporting Documentation
Supporting Documentation
Attachments must not exceed 20 MB and must be one of the following types: .doc, .docx, .xls, .xlsx, .txt, .jpg, .jpeg, or .png

If you are unable to attach the documentation electronically, please indicate below in the "Summary of Complaint" a brief description of documentation you have. An investigator may contact you and ask to have it mailed or faxed to our agency if the documentation is needed.

Max # of Characters: 2000

By entering my name and submitting this electronically, I do hereby affirm under penalties of perjury that the above-stated information is true and correct to the best of my knowledge, information, and belief.