State, County, and Local Governments Employee Complaint Form

If you are an employee of a state agency, county government, a municipality, or any division thereof, a water district, sewer district, school district or any other quasi-municipal agency and want to report a safety or health violation, or believes the employer has discriminated or retaliated against you for reporting an unsafe condition, please fill out the online-form below, or download and fill out the paper form.

If you have any questions about filing a complaint, completing this form, or have a wage & hour concern or complaint please call 207-623-7900: