Request for Payment of Wages Other Than Weekly

Wage & Hour > Request for Payment of Wages Other Than Weekly

Welcome to the online version of the Request for Payment of Wages Other Than Weekly Form. Please select a frequency of payment option from one of the choices below. Do not pay this way until you have received approval from the NH Department of Labor or you will be subject to civil penalties.

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	Bi-Weekly
	Semi-Monthly
	Monthly
	Other

Please fill in the information below. Make sure you enter your own company information, name and email address, even if you are submitting this form on behalf of another company.

Company Name:
Address:
City:
State:
Zip Code:
Phone Number:
Contact Name:
Email:
Are you submitting this form on behalf of another company?
Yes No