Waiver Application - Payment of Minimum Wage
May 10, 2024
submission
#68
Business Information
Employer Business Information
| Business Name | --- |
| Business Phone Number | --- |
| Business Mailing Address | --- |
| Business Location Address | --- |
| Total Number of Employees | --- |
| Business Type | --- |
| Total number of businesses you have within the County of Los Angeles | --- |
| Total number of businesses you have within the City of West Hollywood | --- |
Workforce Information
| Reason for Waiver Request | --- |
Supporting Documentation
Required Supporting Documentation - Declare Bankruptcy or Shutdown
| Submit business’ Profit and Loss (P&L) Statement for the last three calendar years | --- |