Form WH-58 is the U.S. Department of Labor’s Wage and Hour Division receipt that an employee signs to confirm they have received back wages after a federal FLSA investigation.1United States Government Publishing Office. Examining Regulatory and Enforcement Actions Under the Fair Labor Standards Act It is short. It is also consequential: signing it waives the employee’s right to file a private lawsuit under Section 216(b) of the Fair Labor Standards Act for the same unpaid wages.2Office of the Law Revision Counsel. 29 USC 216 – Penalties
When and How the Form Arrives
Form WH-58 shows up at the end of a Wage and Hour Division investigation, after the investigator has reviewed payroll records, interviewed workers, and calculated the minimum wage or overtime shortfall owed to each affected employee.3U.S. Department of Labor. Fact Sheet #44: Visits to Employers The investigator provides one receipt for each employee owed money.
You cannot download WH-58 from the DOL forms page. Employers cannot generate it on their own. It is issued by the investigator assigned to the case and tied to that specific investigation.
The receipt itself records three things: the amount paid to the employee, the pay period the payment covers, and the date payment was made.1United States Government Publishing Office. Examining Regulatory and Enforcement Actions Under the Fair Labor Standards Act It also carries a plain-language notice telling employees that accepting the payment gives up the right to sue under Section 216(b), and instructing them not to sign unless the money is actually in hand.
What Signing Does to an Employee’s Legal Rights
The waiver is written into the statute. An employee’s agreement to accept a supervised payment “shall upon payment in full constitute a waiver” of any right under Section 216(b) to sue for those same unpaid wages plus an equal amount in liquidated damages.2Office of the Law Revision Counsel. 29 USC 216 – Penalties A private lawsuit under Section 216(b) would let an employee pursue unpaid wages, an equal amount in liquidated damages, and attorney’s fees and court costs. Signing the WH-58 closes that route.
The waiver is not open-ended. It reaches only the specific violations, pay periods, and amounts covered by the investigation. New violations after the investigation, or pay periods the investigator did not examine, are not released.
The 2025 Change on Liquidated Damages
Under Field Assistance Bulletin 2025-3, issued June 27, 2025, the Wage and Hour Division no longer seeks, imposes, or collects liquidated damages in any pre-litigation administrative settlement. The DOL’s position is that Section 216(c) authorizes it to supervise payment of unpaid wages or overtime only, and that liquidated damages are a matter for the courts.4U.S. Department of Labor. Field Assistance Bulletin No. 2025-3
For an employee, this sharpens the choice. The amount on a WH-58 will reflect the unpaid wages, and nothing doubled on top. Signing gets you the base wages and closes off a private suit where a court could award twice that figure.
Can You Refuse to Sign?
Yes. Nothing compels an employee to sign. Declining the supervised payment preserves your right to sue under Section 216(b). The wages the employer owes do not disappear because you refused the receipt; the administrative case may simply not close, and you would pursue the claim yourself.
How Employers Complete and File the Form
The employer’s obligations after a supervised payment are set out at 29 CFR 516.2(b). There are three parts.5eCFR. 29 CFR Part 516 – Records to Be Kept by Employers
- Enter the amount paid to each employee, the period covered, and the date of payment on your existing payroll records.
- Give a copy of the signed WH-58 to the employee and keep a copy in your files.
- Send the original signed form to the WHD investigator or authorized representative within 10 days after payment.
The 10-day filing window is firm. Missing it can delay case closure and draw further scrutiny. The practical sequence: issue the check, have the employee sign the receipt, hand over the employee’s copy, retain yours, and send the original to the investigator’s office. The WHD keeps a directory of local offices at dol.gov/agencies/whd/contact/local-offices.
Recordkeeping and the Kickback Rule
The employer’s copy of the WH-58 becomes part of the payroll file. Under 29 CFR 516.5, payroll records must be preserved for at least three years from the date of the last entry.6eCFR. 29 CFR 516.5 – Records to Be Preserved 3 Years This matches the standard FLSA retention period.7U.S. Department of Labor. Fact Sheet #21: Recordkeeping Requirements Under the Fair Labor Standards Act The signed receipt paired with the payroll entry is what proves the debt was satisfied if a question comes up later.
Investigators sometimes contact employees after payment to confirm the money was actually received and that no part of it was returned to the employer. Under 29 CFR 531.35, wages must be paid “free and clear,” and any arrangement in which an employee kicks back part of a back wage payment is itself a separate FLSA violation.8eCFR. 29 CFR 531.35 – Free and Clear Payment; Kickbacks
When the Employee Cannot Be Located
Back wages do not revert to the employer when a worker cannot be found to sign the WH-58. The Wage and Hour Division holds the money for three years and continues efforts to locate the worker. After three years, unclaimed funds go to the U.S. Treasury.9U.S. Department of Labor. Workers Owed Wages
If you think a former employer owed you back wages from a WHD case, you can search the Workers Owed Wages database at webapps.dol.gov/wow by employer name or state and submit a claim through the site. The WHD processes claims in about six weeks.