← FORMVANA NC FORMS
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01
ATTORNEY INFORMATION
02
COURT & CASE INFORMATION
03
PLAINTIFF (EMPLOYEE)
04
DEFENDANT (EMPLOYER)
05
EMPLOYMENT INFORMATION
Still currently employed by this employer
06
PAY PERIODS WITH UNPAID WAGES
PAY PERIOD
HRS WORKED
AMT PAID ($)
AMT OWED ($) *
TOTAL UNPAID WAGES
$0.00
07
TYPE OF VIOLATION
Unpaid overtime (1.5× for hours over 40/week)
Unpaid minimum wage
Withheld last paycheck
Illegal wage deductions
Tip theft
Failure to pay promised bonus or commission
Bounced paycheck
Failure to pay for all hours worked
Other
08
LIQUIDATED DAMAGES & ATTORNEY'S FEES
TOTAL UNPAID WAGES
LIQUIDATED DAMAGES REQUESTED
Equal to unpaid wages under G.S. 95-25.22
TOTAL DAMAGES
$0.00
ATTORNEY'S FEES REQUESTED
Awarded by court under G.S. 95-25.22(d)
09
ATTORNEY CERTIFICATION
I certify that the allegations in this complaint are supported by a reasonable investigation into the facts and law.
I certify that I have advised my client that retaliation for filing a wage claim is prohibited under G.S. 95-25.20.
SELECTED COUNTY
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OPEN CLAWDE VERSION →NC WAGE AND HOUR ACT
- NC minimum wage: $7.25/hr (federal FLSA also applies)
- Overtime at 1.5× for hours over 40/week
- Final paycheck due on next regular payday after termination
- Liquidated damages = 100% of unpaid wages (double recovery possible)
- 2-year statute of limitations (3 years if willful)
- Can file with NCDOL OR directly in Superior Court
- NCDOL complaint is free but recovery limited
- Court action allows attorney's fees + full damages
- Class action possible if multiple employees affected
- Document everything: time records, pay stubs, offer letter, texts/emails
- Retaliation for filing a wage claim is illegal
STATUTORY REFERENCE
G.S. 95-25.1 et seq.NC Wage and Hour Act
G.S. 95-25.6Timing of wage payments
G.S. 95-25.7Final paycheck on termination
G.S. 95-25.22Liquidated damages + fees
G.S. 95-25.20Anti-retaliation protection
29 U.S.C. § 207Federal FLSA overtime