Free Delaware Payroll Report PDF Template Fill Out Form Here

Free Delaware Payroll Report PDF Template

The Delaware Payroll Report form is a crucial document that contractors and subcontractors must submit to the Delaware Department of Labor. This report details the wages paid to employees working on public projects, ensuring compliance with state prevailing wage laws. By accurately completing this form, employers affirm that all workers have received their due compensation and that the information provided is truthful and complete.

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Outline

The Delaware Payroll Report form is an essential document used by contractors and subcontractors engaged in public projects within the state. This form serves multiple purposes, including the accurate reporting of employee wages and hours worked, as well as ensuring compliance with prevailing wage laws. Each report requires detailed information about the project, including the project location, contract number, and the date of the prevailing wage determination. Employers must list the names, social security numbers, and classifications of employees, alongside their total hours worked and gross wages earned for each pay period. The form also mandates the disclosure of deductions made from wages, ensuring that only permissible deductions are reported. Additionally, employers must confirm that all employees have been paid their full wages and that any apprentices are registered in a legitimate apprenticeship program. Failure to submit this report weekly can result in significant fines, emphasizing the importance of accuracy and timeliness. The form concludes with a certification statement, which must be signed and notarized, affirming the truthfulness of the reported information.

Preview - Delaware Payroll Report Form

 

PAYROLL REPORT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

of Labor

ADDRESS:

 

 

 

 

 

 

 

 

 

 

 

 

 

DelawareDepartmentof Labor

 

 

 

 

 

 

 

 

 

 

 

 

NAME OF CONTRACTOR [ ] OR SUBCONTRACTOR [ ]

 

 

 

 

 

 

 

 

 

State of Delaware

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Division of Industrial Affairs

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Department of Labor

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

225 Corporate Boulevard

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4425 N. Market Street

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Suite 104

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Wilmington, DE 19802

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Newark, DE 19702

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

302-761-8200

 

 

 

 

 

 

 

 

PHONE:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

302-451-3423

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PROJECT AND LOCATION

 

WEEK ENDING DATE

 

 

 

 

 

 

CONTRACT NUMBER

DATE OF PREVAILING WAGE DETERMINATION USED ON THIS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PROJECT:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DAY & DATE & HOURS WORKED EACH DAY

 

 

 

DEDUCTIONS

 

HOURLY

 

NAME, ADDRESS AND

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL HOURS &

GROSS

 

 

 

 

 

 

NET

 

 

WORK

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VALUE

 

SOCIAL SECURITY NUMBER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AMOUNT

 

 

 

 

 

 

WAGES

 

CLASSIFICATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RATE OF PAY

 

 

 

 

 

 

 

 

OF EMPLOYEE

 

 

 

M

 

 

T

 

 

W

 

 

T

 

 

F

 

 

S

 

 

S

 

 

HOURS

RATE

EARNED

FICA

FWT

 

SWT

 

 

PAID

OF

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FRINGES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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1.

 

O

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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8.

 

O

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

DATE

I,

 

 

 

(Name of signatory party)

 

(Title)

do hereby state:

 

 

1.That I pay or supervise the payment of persons employed by

 

 

 

 

 

 

 

 

 

 

on the

(Contractor or Subcontractor)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

:

(public project)

 

 

 

 

 

 

 

 

that during the payroll period commencing on the

 

day of

 

, 20

 

and ending on the

 

 

day of

 

 

 

 

 

 

 

 

 

 

, 20

 

 

 

all persons employed on said project

have been paid the full weekly wages earned, that no rebates have been or will be made either directly or indirectly to or on behalf of the contractor or subcontractor 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 defined in the prevailing wage regulations of the State of Delaware.

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 laborers or mechanics contained therein are not less than applicable wage rates contained in any wage determination incorporated into the contract; that the classifications set forth therein for each laborer or mechanic conform with the 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, and that the worksite ratio of apprentices to mechanics does not exceed the ratio permitted by the prevailing wage regulations of the State of Delaware.

An employer who fails to submit sworn payroll information to the Department of Labor weekly shall be subject to fines of $1,000.00 and $5,000. for each violation.

List only those fringe benefits:

For which the employer has paid; and

Which have been used to offset the full prevailing wage rate.

(See Delaware Prevailing Wage Regulations for explanation of how hourly value of benefits is the be computed.)

HOURLY COST OF BENEFITS

(List in same order shown on front of record)

Employee

1.

2.

3.

4.

5.

6.

7.

8.

I hereby certify that the foregoing information is true and correct to the best of m knowledge and belief. I realize that making a false statement under oath is a crime in State of Delaware

Signature

STATE OF

COUNTY OF

SWORN TO AND SUBSCRIBED BEFORE ME, A NOTARY PUBLIC,

THIS

 

DAY OF

 

, A.D. 20

 

.

Notary Public

Form Details

Fact Name Description
Governing Law The Delaware Payroll Report form is governed by the Delaware Prevailing Wage Regulations.
Purpose This form is used to report payroll information for contractors and subcontractors working on public projects in Delaware.
Submission Frequency Employers must submit the payroll report weekly to the Delaware Department of Labor.
Information Required The form requires details such as employee names, hours worked, wages, and deductions.
Consequences of Non-Compliance Failure to submit accurate payroll reports may result in fines ranging from $1,000 to $5,000 for each violation.
Certification The signatory must certify that the information provided is accurate and complete under penalty of perjury.
Fringe Benefits Employers must list only those fringe benefits that have been paid and used to offset the prevailing wage rate.
Notary Requirement The completed form must be sworn to and subscribed before a notary public.
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