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.  Either mail or fax your completed form, but do not do both.  Mail one original copy to Equal Rights Division, P.O. Box 8928, Madison, WI 53708 or fax to (608) 267-4592.  APPLY EARLY! Allow 30 days to have your application processed. The STATUTORY AUTHORITY for the use of this form is specified in ss. 66.0903 and 103.49, Stats., and Ch, DWD 290 of the Wis. Adm. Code. THE USE OF THIS FORM IS MANDATORY. Call (608) 266-6861 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/128 KB)

ERD-5719 (Print Version - pdf/58 KB)

*** If you need to access this form in an alternate format, please send an email to the Content Contact listed above.

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