Free No Work Performed Statement for Certified Payroll

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Your business

Business name *

Filing as

Business address

Prime contractor (the company you work under)

Project and week

Project name *

Project or contract number

Project city or county

Project state

Week ending *

Payroll number (only if your agency asks)

Reason (optional)

Who signs

Name *

Title

Date

Phone

If your contract or agency supplies its own no-work form or asks for a WH-347 marked "no work performed," use that instead. Only sign a statement that is true for the week shown.

Covered work this week? Fill out your WH-347 in the free generator. Want the rules first? Read No Work Performed weeks on certified payroll.