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Home > Forms Repository > Application for Prevailing Wage Rate Determination, ERD-5719-E

Application for Prevailing Wage Rate Determination

Document Number:  ERD-5719-E

Description:  All 3 pages of this form MUST be completed or the application will be returned. Mail one original copy to Equal Rights Division, P.O. Box 8928, Madison, WI 53708. Applications may NOT be faxed.  APPLY EARLY! Allow 30 days to have your application processed. The STATUTORY AUTHORITY for the use of this form is specified in ss. 66.293 and 103.49, Stats., and Ch, DWD 290 of the Wis. Adm. Code. THE USE OF THIS FORM IS MANDATORY. Call (608) 266-0028 if you have questions. Personally identifiable information you provide may be used for secondary purposes. See s.15.04 (1)(m), Stats. for details.

Comments:  This form is available as an electronic Microsoft Word template or an Adobe PDF.

Content Contact:  Equal Rights Information

Document Attachments:

ERD-5719-E (Electronic Version - Word/180 KB)  Fill in online, print and save.  You must have MS Word to save the completed form.

ERD-5719 (Print Version - pdf/45 KB)  Print and fill in by hand.  This version can not be completed online but can be printed and filled in by hand.  This format will work with all computer operating systems.  This requires the free Adobe Acrobat Reader to view and print the blank form.

***Should you require the necessary software to view the above attachment, please go to the DWD Viewers Download Page.  Links to each specific vendor's site have been provided for you.  Thank you.

Updated January 06, 2009