Blank Oregon Payroll Wh 38 Form Open Editor Now

Blank Oregon Payroll Wh 38 Form

The Oregon Payroll WH-38 form is a document used by contractors and subcontractors to report payroll information for public works projects. This form ensures compliance with state and federal wage laws, including the Oregon Prevailing Wage Rate law and the Davis-Bacon Act. Accurate completion of the WH-38 is essential for maintaining transparency and legality in payroll practices on public contracts.

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The Oregon Payroll WH-38 form is a crucial document for contractors and subcontractors involved in public works projects in the state of Oregon. This form serves multiple purposes, primarily ensuring compliance with state and federal wage laws, including the Oregon Prevailing Wage Rate (PWR) law and the federal Davis-Bacon Act. It collects essential information about the project, such as the business name, project location, and pay period dates. The form requires contractors to report detailed payroll information, including employee classifications, hours worked, gross wages, and any fringe benefits provided. By signing the certified statement section, contractors affirm that all workers have been paid appropriately and that no illegal deductions have occurred. It is important to note that the form must be submitted alongside payroll records to the relevant public agency, reinforcing transparency and accountability in labor practices. Understanding the WH-38 form is vital for maintaining compliance and avoiding potential legal issues, making it an indispensable tool for those in the construction and contracting industries.

Form Example

BUREAU OF LABOR AND INDUSTRIES

 

 

 

PAYROLL/CERTIFIED STATEMENT FORM WH-38

WAGE AND HOUR DIVISION

 

 

 

FOR USE IN COMPLYING WITH ORS 279C.845*

PRIME CONTRACTOR

SUBCONTRACTOR

PAYROLL NO.________________________

Business Name (DBA):

 

Phone: (

)

CCB Registration Number:

Project Name:

 

Project Number:

 

Type of Work:

Street Address:

 

 

Project Location:

 

Mailing Address:

Project County:

Date Pay Period Began:

 

 

Date Pay Period Ended:

 

 

 

 

 

 

 

 

THIS SECTION FOR PRIME CONTRACTORS ONLY

 

 

 

THIS SECTION FOR SUBCONTRACTORS ONLY

 

Public Contracting Agency Name:

 

 

 

 

 

 

 

Subcontract Amount:

 

 

 

 

 

 

 

 

 

 

 

Prime Contractor Business Name (DBA):

 

 

 

Phone: (

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Prime Contractor Phone: (

)

 

 

 

Date Contract Specifications First Advertised for Bid:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Prime Contractor’s CCB Registration Number:

 

 

 

Contract Amount:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Date You Began Work on the Project:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(1)

 

(2)

 

 

(3) DAY AND DATE

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

 

 

 

 

 

 

 

 

 

 

 

 

 

HOURLY

 

 

 

HOURLY FRINGE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FRINGE

 

 

 

 

NAME , ADDRESS AND

CLASSIFICATION

 

 

 

 

 

 

 

 

 

GROSS

ITEMIZED

 

BENEFITS PAID

NAME OF BENEFIT

 

 

 

 

 

 

 

 

HOURLY

BENEFIT

 

EMPLOYEE’S

 

(INCLUDE GROUP #

 

 

 

 

 

 

 

 

TOTAL

AMOUNT

DEDUCTIONS

NET WAGES

TO BENEFIT

PARTY, PLAN,

 

 

 

 

 

 

 

 

 

BASE

AMOUNTS

IDENTIFICATION

AND APPRENTICESHIP

 

 

 

 

 

 

 

HOURS

EARNED (see

FICA, FED,

PAID

PARTY, PLAN,

FUND, OR

 

 

 

 

 

 

 

RATE

PAID AS

NUMBER

 

STEP IF APPLICABLE)

 

 

 

 

 

 

 

 

directions)

STATE, ETC.

 

FUND, OR

PROGRAM

 

 

 

 

 

 

 

 

 

 

WAGES TO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PROGRAM

 

 

 

 

 

 

HOURS WORKED EACH DAY

 

 

EMPLOYEE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OT

ST

OT

ST

OT

ST

OT

ST

OT

ST

*Although this form has not been officially approved by the U.S. Department of Labor, it is designed to meet the requirements of both the state PWR law and the federal Davis-Bacon Act.

WH-38 (Rev. 11-09)

THIS FORM CONTINUED ON REVERSE

CERTIFIED STATEMENT

Date:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I,

 

 

 

 

,

 

 

 

 

 

 

 

 

(NAME OF SIGNATORY PARTY)

 

 

(TITLE)

 

 

do hereby state:

 

 

 

 

 

 

 

 

 

 

 

 

 

(1) That I pay or supervise the payment of the persons employed by:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(CONTRACTOR, SUBCONTRACTOR OR SURETY)

 

 

on the

 

 

 

 

 

 

 

 

 

; that during the payroll period

 

 

 

 

(BUILDING OR WORK)

 

 

 

 

 

 

commencing on the

 

day of

 

,

 

 

, and ending the

 

day

 

 

 

 

 

 

 

 

 

 

(MONTH)

 

(YEAR)

 

 

of

 

,

 

 

, all persons employed on said project have been paid the

 

 

(MONTH)

 

(YEAR)

 

 

 

 

 

 

full weekly wages earned, that no rebates have been or will be made either directly or indirectly to or on behalf of said

(CONTRACTOR, SUBCONTRACTOR OR SURETY)

from the full weekly wages earned by any person, and that no deductions have been made either directly or indirectly from the full wages earned by any person, other than permissible deductions as specified in ORS 652.610, and as defined in Regulations, Part 3 (29 CFR Subtitle A), issued by the Secretary of Labor under the Copeland Act, as amended (48 Stat. 948, 63 Stat. 108, 72 Stat. 967; 76 Stat. 357; 40 U.S.C. 276c), and described below:

(2)That any payrolls otherwise under this contract required to be submitted for the above period are correct and complete; that the wage rates for workers contained therein are not less than the applicable wage rates contained in any wage determination incorporated into the contract; that the classifications set forth therein for each worker conform with work performed.

(3)That any apprentices employed in the above period are duly registered in a bona fide apprenticeship program registered with a state apprenticeship agency recognized by the Bureau of Apprenticeship and Training, United States Department of Labor, or if no such recognized agency exists in a state, are registered with the Bureau of Apprenticeship and Training, United States Department of Labor.

I HAVE READ THIS CERTIFIED STATEMENT, KNOW THE CONTENTS THEREOF AND IT IS TRUE TO MY KNOWLEDGE:

(NAME AND TITLE)

(SIGNATURE AND DATE)

In addition to completing sections (1) - (3), if your project is subject to the federal Davis-Bacon Act requirements, complete the following section as well:

(4) That:

(a)WHERE FRINGE BENEFITS ARE PAID TO APPROVED PLANS, FUNDS OR PROGRAMS

-In addition to the basic hourly wage rates paid to each laborer or mechanic listed in the above referenced payroll, payments of fringe benefits as listed in the contract have been or will be made to appropriate programs for the benefit of such employees, except as noted in Section 4(c) below.

(b)WHERE FRINGE BENEFITS ARE PAID IN CASH

-Each laborer or mechanic listed in the above referenced payroll has been paid, as indicated on the payroll, an amount not less than the sum of the applicable basic hourly wage rate plus the amount of the required fringe benefits as listed in the contract, except as noted in Section 4(c) below.

(c) EXCEPTIONS:

EXCEPTION (CRAFT)

EXPLANATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

REMARKS:

NAME AND TITLE

SIGNATURE

THE WILLFUL FALSIFICATION OF ANY OF THE ABOVE STATEMENTS MAY SUBJECT THE CONTRACTOR OR SUBCONTRACTOR TO CIVIL OR CRIMINAL PROSECUTION. SEE SECTION 1001 OF TITLE 18 AND SECTION 231 OF TITLE 31 OF THE UNITED STATES CODE.

FILE THIS FORM WITH THE PUBLIC AGENCY ASSOCIATED WITH THE PROJECT

NOTE TO CONTRACTORS: YOU MUST ATTACH COPIES OF THIS FORM TO EACH OF YOUR PAYROLL SUBMISSIONS ON THIS PROJECT.

INSTRUCTIONS AND ADDITIONAL FORMS ARE AVAILABLE ON OUR WEBSITE: WWW.OREGON.GOV/BOLI.

WH-38 (Rev. 11-09)

Document Characteristics

Fact Name Description
Purpose The WH-38 form is used to comply with Oregon's prevailing wage laws and the federal Davis-Bacon Act.
Governing Law This form is governed by ORS 279C.845, which outlines requirements for public contracts in Oregon.
Submission Requirement Contractors must attach copies of the WH-38 form to each payroll submission for the project.
Certification The form includes a certified statement confirming that all employees have been paid their full wages without unauthorized deductions.
Fringe Benefits Employers must report fringe benefits paid to employees, either through approved plans or in cash, as required by the contract.
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