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This form is intended to meet compliance with New York State Labor Law Section 195(1) Notice and Acknowledgement of Wage Rate and Designated Payday, for non-exempt and student employees.
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How to fill out employee pay notification form

How to fill out EMPLOYEE PAY NOTIFICATION FORM
01
Obtain the EMPLOYEE PAY NOTIFICATION FORM from the HR department.
02
Fill in the employee's full name at the top of the form.
03
Enter the employee's job title and department.
04
Provide the employee's ID number or social security number.
05
Indicate the pay period start and end dates.
06
Fill in the hours worked and the applicable pay rate.
07
Calculate the total earnings and fill it in the designated section.
08
Include any deductions, such as taxes or benefits.
09
Review all information for accuracy.
10
Sign and date the form before submitting it to HR.
Who needs EMPLOYEE PAY NOTIFICATION FORM?
01
All employees who receive a paycheck from the organization.
02
HR personnel for record-keeping and payroll processing.
03
Managers or supervisors who need to verify employee hours and pay.
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People Also Ask about
What is the wage theft law in NY?
Employers that do not give wage statements may have to pay damages of up to $250 per day, per employee, unless they paid employees all wages required by law. (This stops at $5,000 per employee in civil lawsuits filed by employees.)
What is the meaning of WTPA?
Wage Theft Prevention. The New York State Wage Theft Prevention Act (WTPA) went into effect April 9, 2011 and amends the notice of wage rate requirements and expands the civil and criminal remedies that are available when employers fail to comply with these provisions.
What is Section 195.1 of the New York State Labor law Notice for hourly rate employees?
Notice and Acknowledgement of Pay Rate and Payday Under Section 195.1 of the New York State Labor Law Notice for Hourly Rate Employees LS 54 is a blank work agreement that contains all of the fields that employers must include to notify each employee in writing of conditions of employment at time of commitment to hire.
What is the penalty for wage notice in NY?
The law requires employers to give written notice of wage rates to each new hire. The notice must include: Rate or rates of pay, including overtime rate of pay (if it applies) How the employee is paid: by the hour, shift, day, week, commission, etc.
What is New York state minimum wage 2025?
Colorado and California treat intentional underpayment or withholding of wages as criminal theft.
Is wage theft a criminal offense?
If any data in the notice changes, the employer must tell employees at least a week before it happens unless they issue a new paystub that carries the notice. Failing to give notice means paying damages of up to $50 per day, per employee, unless you paid your employee all wages required by law.
What is LS54?
Required Notice of Pay Rate (LS 54) The Wage Theft Prevention Act (WTPA) took effect on April 9, 2011. The law requires employers to give written notice of wage rates to each new hire. The notice must include: Rate or rates of pay, including overtime rate of pay (if it applies)
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What is EMPLOYEE PAY NOTIFICATION FORM?
The Employee Pay Notification Form is a document used by employers to inform relevant authorities or departments about the details of employee compensation, including salaries, bonuses, and other forms of payment.
Who is required to file EMPLOYEE PAY NOTIFICATION FORM?
Employers are required to file the Employee Pay Notification Form for all employees on payroll, particularly when there are new hires, terminations, or changes in pay.
How to fill out EMPLOYEE PAY NOTIFICATION FORM?
To fill out the Employee Pay Notification Form, employers need to provide the employee's personal information, job title, pay rate, payment frequency, and any applicable deductions or benefits.
What is the purpose of EMPLOYEE PAY NOTIFICATION FORM?
The purpose of the Employee Pay Notification Form is to ensure transparency and compliance with labor laws by documenting how employees are compensated and to facilitate accurate payroll processing.
What information must be reported on EMPLOYEE PAY NOTIFICATION FORM?
The information that must be reported on the Employee Pay Notification Form includes the employee's name, Social Security number or ID, job title, department, pay rate, payment schedule, and details of any bonuses or deductions.
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