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PAGA New PAGA Claim Notice

Private Attorneys General Act (PAGA) - Filing 

New PAGA Claim Notice 

Your Information (Person Who is Filing)

Plaintiff Information

Employer Information

Maximum 80 Character Limit

Notice General Information

Please click the field to select date.
Notice Violations - Check All that Apply * 

PAGA Claim Type - Check All that Apply *
Filing Fee
I declare that I have or will pay the filing fees required by statute [Labor Code section 2699.3(a)(1)(B)] according to the instructions on the PAGA home page, unless I have claimed in forma pauperis by checking the box below. 

Notice and Other Attachments

Must be a PDF

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