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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.________________________ FINAL PAYROLL 

Business Name (DBA): Phone: ( ) CCB Registration Number:

Project Name: Project Number: Type of Work:

Street Address:

Mailing Address:

Project Location:

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:

Phone: ( )

Date Contract Specifications First Advertised for Bid:

Contract Amount:

Subcontract Amount:

Prime Contractor Business Name (DBA):

Prime Contractor Phone: ( )

Prime Contractor’s CCB Registration Number:

Date You Began Work on the Project:

(1)

(2)

(3) DAY AND DATE

(4)

(5)

(6)

(7)

(8)

(9)

(10)

(11)

NAME, ADDRESS AND

EMPLOYEE’S

IDENTIFICATION

NUMBER

CLASSIFICATION

(INCLUDE GROUP #

AND APPRENTICESHIP

STEP IF APPLICABLE)

TOTAL

HOURS

HOURLY

BASE

RATE

HOURLY

FRINGE

BENEFIT

AMOUNTS

PAID AS

WAGES TO

EMPLOYEE

GROSS

AMOUNT

EARNED (see

directions)

ITEMIZED

DEDUCTIONS

FICA, FED,

STATE, ETC.

NET WAGES

PAID

HOURLY FRINGE

BENEFITS PAID

TO BENEFIT

PARTY, PLAN,

FUND, OR

PROGRAM

NAME OF BENEFIT

PARTY, PLAN,

FUND, OR

PROGRAM

HOURS WORKED EACH DAY

Schedule: 5/8 4/10 ; Reg. Hrly. Schd: to.

*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. 05/16) 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.

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. 05/16)

↓ Oregon Payroll Wh 38 PDF Form

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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