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Youth Law Complaint Introduction

This form is used to report employers who may be in violation of the Colorado Youth Employment Opportunity Act. It must be filled in completely and signed and dated. Failure to do so will delay the processing of this complaint.

If you have questions, please contact the Division by phone at 303-318-8441 or email at cdle_labor_standards@state.co.us. Note: This form is for youth law matters only. If you believe the minor is also owed wages by this employer, you must file a separate claim by completing a Labor Standards Complaint Form.

To request a reasonable accommodation, or this form in an alternate accessible format, please refer to our department's Accessibility website and complete the Accessibility Feedback Form .

Youth Law Complaint

Employer Information

Please complete this information about the Employer.

Name of Business or Employer	First Name of Business Contact
Last Name of Business Contact	Title of Business Contact
Business Mailing Address (often found on pay statements or paychecks)	Mailing City
Mailing State	Mailing Zip
Employer’s Website	Daytime Telephone #
Alternate Telephone #	Email Address e.g.(@somplace.com)

Individual Liability (People Who Control the Business) Responsible For Your Complaint

The Colorado Youth Employment Opportunity Act allows persons to file complaints against businesses as well as against people with enough control over the businesses. Under the law, this would include any agent, manager, superintendent or foreperson of any firm or corporation who violates or fails to comply with the law. C.R.S. § 8-12-116. If you believe a person has enough control, the Division can add them to the investigation and determine whether the business and the person are both responsible for your complaint.

I would like the business and this person to be named in the investigation.

Individually Liable Party's First Name	Individually Liable Party's Last Name
Individually Liable Party's Title	Individually Liable Party's Role
Individually Liable Party's Mailing Address	Mailing City
Mailing State	Mailing Zip
Telephone #	Email Address e.g.(@somplace.com)

Youth Law Complaint

Upload Supporting Documentation

Do you want to add Supporting Documentation?

YesNo

Supporting Documentation (check all that apply)

Pay StatementsTime CardsPaychecksOther Information

Please upload all relevant files. Please note that file names should not include special characters such as colons (:). Adding a file with a colon in the name will result in the failure of the claim submission.

Please do not leave any of the additional file upload sections empty. If you have selected "Add Another File," but will no longer upload another file you must delete this section. If you see "No File Chosen," please select "Delete" in that file upload section.

Youth Law Complaint

Agreement and Signature

By signing this “Youth Law Complaint” you are agreeing to the following:

I have been notified and understand that any person providing false information to the Division in order to obtain and/or retain anything of value may be subject to criminal prosecution under the laws of the State of Colorado with possible penalties of imprisonment, fines, or both.
I hereby certify that this is a true statement, and authorize the Division to investigate and assist in this matter.
I understand that the Division does not guarantee a resolution to this dispute, and that I may have to pursue the matter further in court, with an attorney, with another agency, or through other methods.
I understand that any information supplied to the Division may be provided to the employer, the agents of the employer involved in the dispute, and other agencies or individuals as the Division deems appropriate.
I declare under penalty of perjury 18-5-501, et seq., C.R.S. that the information provided is true and correct

By typing my name below I am entering it as my electronic signature and agreeing to the statements above.

Complainant's typed electronic signature

Minor's typed electronic signature

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Minor's First & Last Name	Minor Age
Minor’s Job Title	Date work started for the employer. MM/DD/YYYY
Last date worked for the employer (if applicable) MM/DD/YYYY	Duties Performed:

Youth Law Complaint Introduction

Youth Law Complaint

Minor Information

Complainant Information

Minor Information

Type of Allegation

Youth Law Complaint

Employer Information

Individual Liability (People Who Control the Business) Responsible For Your Complaint

Youth Law Complaint

Upload Supporting Documentation

Youth Law Complaint

Agreement and Signature

Title	First Name
Last Name	Email Address e.g.(@somplace.com)
Telephone #	Mailing Address (Street/PO Box) This is the address where mail is sent to you. Sometimes this is different than the physical address where you live.
Mailing City	Mailing State
Mailing Zip	Age
Job Title	Date work started for the employer. MM/DD/YYYY
Last date worked for the employer (if applicable) MM/DD/YYYY	Duties Performed:
Are additional Minors Involved? YesNoUnknown