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PAGA Amended PAGA Claim Notice

Private Attorneys General Act (PAGA) - Filing

Amended PAGA Claim Notice

Please enter only the eight digit number after "LWDA-CM-" in the following format, "XXXXXX-XX".
Your Information (Attorney or Employee - Whoever is Filing)

Plaintiff/Aggrieved Employee Information

Employer Information

Amended Notice Detail
Please provide the details of the amendments to the original notice.

Amended Notice

Should you have questions regarding this online form, please contact PAGAInfo@dir.ca.gov