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In the landscape of employment law in New York State, the Notice and Acknowledgement of Pay Rate and Payday stands out as a critical document that encapsulates the essence of transparent and lawful employment practices. Rooted firmly in the guidelines set forth under Section 195.1 of the New York State Labor Law, this form serves a dual purpose: ensuring employees are well-informed about their pay rate, allowable deductions, overtime entitlements, and paydays; and solidifying the employer's commitment to adhere to state labor laws. It outlines a structured framework for communicating the specifics of an employee's compensation, including but not limited to, their hourly wage, claimed allowances such as tips, meals, and lodging, and the frequency of their pay. Additionally, the document also touches on the law’s stance on equal pay for equal work and the prohibition against wage discussion restrictions amongst coworkers, highlighting the state’s dedication to fostering an equitable work environment. This form, which must be presented to employees at the time of hiring or before any changes to pay rates or paydays, is not merely a procedural necessity but a testament to the rights and responsibilities binding employees and employers in New York State.

Ny Notice And Acknowledgement Of Pay Rate Sample

Notice and Acknowledgement of Pay Rate and Payday/工资与发薪日通知与确认书

Under Section 195.1 of the New York State Labor Law/根据纽约州劳动法 (Labor Law) 第 195.1 条

Notice for Hourly Rate Employees/时薪员工通知

1. Employer Information/雇主信息

Name/名称:

Doing Business As (DBA) Name(s)/经营 (DBA) 名称:

FEIN (optional)/FEIN(选填):

Physical Address/实际地址:

Mailing Address/邮寄地址:

Phone/电话:

2.Notice given/通知时间:

At hiring/聘用时

Before a change in pay rate(s), allowances claimed or payday/工资、补助或发薪日变化之前

3. Employee’s rate of pay/员工工资:

$per hour/每小时

4.Allowances taken/补助:

None/无

 

 

 

 

Tips/小费

 

per hour/每小时

Meals/伙食

 

 

per meal/每餐

Lodging/住宿

 

 

 

 

 

Other/其他

 

 

 

 

 

5.Regular payday/固定发薪日

6.Pay is/发薪周期:

Weekly/每周

Bi-weekly/两周

Other/其他

7. Overtime Pay Rate/加班费:

$per hour (This must be at least 1½ times the worker’s regular rate with few exceptions.)/每小时 (必须至少为工人正常工资的 1.5 倍,少数例外。)

8. Employee Acknowledgement/员工确认:

On this day I have been notified of my pay rate, overtime rate (if eligible), allowances, and designated pay day on the date given below. I told my employer what my primary language is./本人于下方日期收到关于工资、加班 费(如有资格)、补助和指定发薪日的通知。本人已告诉 雇主本人的主要语言是什么。

Check one/请勾选一项:

I have been given this pay notice in English because it is my primary language./本人已收到此英语薪资通知, 因为英语是本人的主要语言。

My primary language is/本人的主要语言是 。

I have been given this pay notice in English only, because the Department of Labor does not yet offer a pay notice form in my primary language./本人已收到此全 为英语的薪资通知,因为劳工署 (Department of Labor) 尚 未提供采用本人主要语言的薪资通知表。

Print Employee Name/正楷书写员工姓名

Employee Signature/员工签名

Date/日期

Preparer’s Name and Title/制表人姓名和职务

The employee must receive a signed copy of this form. The employer must keep the original for

6years./员工必须收到该表格的签名副本。雇主必须将原 件保存 6 年。

Please note: It is unlawful for an employee to be

paid less than an employee of the opposite sex for equal work. Employers also may not prohibit employees from discussing wages with their co-workers./请注意:异性员 工同工不同酬是违法行为。雇主也不得禁止员工与同事讨 论工资。

LS 54C (01/17)

File Overview

Fact Detail
Governing Law Section 195.1 of the New York State Labor Law
Purpose To provide employees with a written notice of their pay rate and payday
Notice Timing At hiring, before a change in pay rate(s), allowances claimed, or payday
Required Information Employer details, employee's rate of pay, allowances, regular payday, pay frequency, and overtime pay rate
Employee Acknowledgement Employees must acknowledge receipt of the notice in their primary language
Document Retention Employers must keep the original notice for 6 years
Equal Pay Notice Unlawful for employees to be paid less than others of the opposite sex for equal work; employees cannot be prohibited from discussing wages

Ny Notice And Acknowledgement Of Pay Rate: Usage Guidelines

Before an employee begins their new role or experiences changes in their pay rate, allowances, or payday, they must complete the New York Notice and Acknowledgement of Pay Rate form. This document ensures transparency between the employer and the employee regarding compensation details. Understanding and accurately completing this form is crucial for keeping records compliant with New York State Labor Laws. Below are the steps needed to fill out the form correctly.

  1. Employer Information: Start by filling out the employer's details, including the legal name and the Doing Business As (DBA) names, if applicable. Though the Federal Employer Identification Number (FEIN) is optional, it's advisable to include it for record-keeping. Enter the physical and mailing addresses of the business and provide a contact phone number.
  2. Notice given: Mark the appropriate box to indicate whether this notice is being provided at the time of hiring, before a change in pay rates, allowances, or payday.
  3. Employee’s rate of pay: Specify the employee's hourly rate of pay in dollars.
  4. Allowances taken: If applicable, itemize any allowances such as tips, meals, lodging, or others. Specify the amount per hour for tips or per meal for food, for instance.
  5. Regular payday: Indicate the employee’s regular payday to clarify when they will receive their wages.
  6. Pay is: Choose the pay period frequency – weekly, bi-weekly, or other. Specify if selecting other.
  7. Overtime Pay Rate: Enter the rate of pay for overtime work. Remember, it should be at least 1.5 times the employee’s regular hourly rate, barring a few exceptions.
  8. Employee Acknowledgement: The employee should confirm their understanding of the pay rate, overtime eligibility, allowances, and payday by checking the appropriate box regarding their primary language. Then, they must print their name, sign, and date the form. Additionally, the preparer of the form should also provide their name and title.

After completing the form, ensure that the employee receives a signed copy for their records. The employer must retain the original document for six years, as per the New York State Labor Law requirements. Remember, this form not only serves as a legal requirement but also promotes a transparent and fair work environment by affirming the employee's compensation terms. Moreover, employers and employees are reminded through this form that pay discrimination based on sex and discussing wages among co-workers are contrary to the law. Keeping accurate and up-to-date records of these acknowledgments safeguards both parties and fosters a positive working relationship.

FAQ

  1. What is the purpose of the Notice and Acknowledgement of Pay Rate form?

    This form is designed to ensure that employees are fully aware of their pay rate, overtime rate, if applicable, any allowances such as tips, meals, or lodging that they are entitled to, and their designated payday. It's a tool for transparency and accountability in the employment relationship, helping to prevent misunderstandings regarding compensation.

  2. When should an employer give this form to an employee?

    An employer must provide this form at two critical times: firstly, at the time of hiring, before the employee has begun work; and secondly, before any change in the pay rate, allowances, or payday. This ensures that employees are always up to date with their pay details.

  3. Is it mandatory to fill out the entire form, including the optional FEIN section?

    While the form requires comprehensive information about the employer and the employment terms, the FEIN (Federal Employer Identification Number) section is optional. However, filling out the rest of the form in full is mandatory to meet the legal requirements.

  4. What are the allowances mentioned, and how are they defined?

    Allowances are specific types of compensation over the base pay. They can include tips (extra money given by customers for services), meal allowances (compensation for meals during work hours), lodging (if the employer provides accommodation), and other job-related benefits. Employers must specify the amounts for each allowance taken.

  5. How frequently should paydays occur according to the form?

    The form does not prescribe a specific frequency for paydays but requires employers to designate a regular payday. It can be weekly, bi-weekly, or another consistent period agreed upon between the employer and employee, ensuring predictability in pay.

  6. What is the importance of the overtime pay rate section?

    Listing the overtime pay rate is crucial for clarifying compensation for hours worked beyond the standard workweek. By law, this rate must be at least 1.5 times the employee's regular rate, with limited exceptions, safeguarding fair compensation for overtime work.

  7. What should an employee do if their primary language is not English?

    If an employee's primary language is not English and the Department of Labor offers a pay notice form in their primary language, they should receive the form in that language. If not available, the form should still be provided in English with an acknowledgment of the primary language.

  8. What happens after the employee signs the form?

    After signing, the employee should receive a copy of the form for their records. The employer, in turn, is required to keep the original document for six years. This process ensures both parties have evidence of the agreed-upon pay details.

  9. Is it legal for employers to prevent employees from discussing wages?

    No, it is illegal for employers to prohibit employees from discussing their wages with co-workers. This provision encourages an open and fair workplace by allowing employees to share and discuss compensation information freely.

  10. What should an employee do if they find a discrepancy in their pay or if they have not received this form?

    If an employee notices any discrepancies in their pay or has not been given the Notice and Acknowledgement of Pay Rate form, they should first address the issue directly with their employer. If the issue is not resolved, they can contact the New York State Department of Labor for guidance and possible intervention. It's essential for employees to advocate for their rights and ensure they are being compensated fairly according to the terms set out in this form.

Common mistakes

When completing the New York Notice and Acknowledgement of Pay Rate form, it's important to pay attention to detail and accuracy to ensure compliance with the labor laws. However, people often make mistakes that can lead to misunderstandings or legal issues down the road. Here are some common errors:

  1. Not providing complete employer information: It's crucial to fill in all the employer information accurately, including the name, Doing Business As (DBA) names if applicable, FEIN (optional but recommended), physical and mailing addresses, and phone number. Leaving out any of these details can result in the form not being compliant with New York State labor laws.

  2. Failing to specify the pay rate clearly: The form requires the employee's rate of pay to be stated clearly, including any allowances such as tips, meals, lodging, or others. Not specifying these rates clearly or omitting them can lead to disputes regarding the employee’s compensation.

  3. Incorrectly identifying the pay period or payday: The form asks for the regular payday and whether the pay is weekly, bi-weekly, or other. Incorrectly marking this section can cause confusion and potentially result in non-compliance with payday regulations, leading to penalties for the employer.

  4. Omitting overtime rates: For eligible employees, the overtime pay rate must be at least 1.5 times the regular rate. Failure to include this information or incorrectly stating the overtime rate can lead to legal issues and financial penalties for underpaid overtime.

It is also important for both the employee and the employer to review all the details on the form before signing it to confirm that all the information provided is accurate and complete. Acknowledgement by the employee, through the correct selection based on their primary language and a signature, is essential to validate the agreement on pay conditions between the employer and the employee. Employers are required to keep the original form for six years, which underscores the importance of accurately completing this document at the outset.

Mistakes made on this form can not only lead to immediate administrative headaches but can also have long-term legal and financial implications. Being thorough and precise benefits both the employee and the employer by fostering a clear understanding of pay rate and conditions of employment under New York State law.

Documents used along the form

In the workplace, especially within New York State, the Notice and Acknowledgement of Pay Rate and Payday form plays a critical role in ensuring transparent and fair communication between employers and their employees regarding pay rates and payday policies. This document, however, is often just one component of a broader suite of employment-related forms and documentation that can help maintain clarity, compliance, and smooth operations. Below are several forms and documents that are frequently used in conjunction with the mentioned pay rate notice.

  • W-4 Form: The Employee's Withholding Certificate lets employees specify their tax withholding preferences to ensure the correct federal income tax is deducted from their paychecks.
  • I-9 Form: The Employment Eligibility Verification form is required by the U.S. government. It verifies an employee's legal right to work in the United States.
  • State Tax Withholding Form: Similar to the W-4 but for state taxes. It allows employees to set their state tax withholding preferences.
  • Direct Deposit Authorization Form: Employees use this to authorize the electronic transfer of their pay directly into their bank accounts, including the necessary bank information.
  • Employee Handbook Acknowledgement Form: This confirms that an employee has received and understands the company’s employee handbook, which outlines important policies and procedures.
  • Emergency Contact Information Form: Collects important contact information for use in case of an emergency involving the employee.
  • Job Description Document: Provides employees with a clear understanding of their job responsibilities, expectations, and requirements.
  • Overtime Policy Acknowledgement Form: Specifically acknowledges receipt and understanding of the company's overtime policies, including compensation rates and the procedure for authorizing overtime work.

Together with the Notice and Acknowledgement of Pay Rate and Payday form, these documents contribute to a comprehensive framework for employment that supports both the employer's and the employees' need for clarity, security, and fairness in the workplace. Staying informed and ensuring these documents are correctly filled out and filed is crucial for maintaining a compliant and efficient work environment.

Similar forms

The W-4 form, officially titled Employee's Withholding Certificate, shares similarities with the NY Notice and Acknowledgement of Pay Rate form primarily in its orientation towards new and existing employees regarding financial aspects of employment. Both forms are essential at the hiring stage or when there's a change in an employee's financial terms. The W-4 form is crucial for determining the amount of federal income tax to withhold from an employee's paycheck, which, like the pay rate notice, plays a critical role in an employee's understanding of their net income.

The I-9 form, Employment Eligibility Verification, while focused on verifying an employee's legal right to work in the United States, shares the procedural necessity of being completed at the time of hire, similar to the NY Notice and Acknowledgement of Pay Rate form. Both documents are mandated by law and require personal information from the employee, albeit for different purposes: one for pay rate acknowledgment and the other for employment eligibility verification.

State-specific New Hire Reporting forms, which employers must submit to report new or rehired employees, share a common purpose with the NY Notice and Acknowledgement of Pay Rate form in terms of compliance with legal requirements aimed at protecting employee rights. Both sets of documentation facilitate government oversight—New Hire Reporting for child support enforcement and the pay rate form for labor law compliance.

The Fair Labor Standards Act (FLSA) Compliance Poster, required to be displayed by employers, and the NY Notice and Acknowledgement of Pay Rate form both serve to inform employees about their rights under labor laws. While the poster provides a broad overview of rights concerning minimum wage, overtime pay, and child labor, the pay rate form gives specific information about an individual's pay details and rights, including anti-discrimination protections similar to those highlighted in the poster.

The Employee Handbook, though not a legal document, typically contains information similar to what is found in the NY Notice and Acknowledgement of Pay Rate form, such as pay structure, payday schedules, and overview of employee benefits and policies. Both are pivotal in setting clear expectations and informing employees about their employment conditions and the company's policies.

Benefits Enrollment Forms for health insurance, retirement plans, and other employee benefits require personal decision-making from the employee about their compensation package, akin to how the NY Notice and Acknowledgement of Pay Rate form details specific pay rate and deductions. Both types of documentation necessitate employee acknowledgment and understanding of their compensation and benefits.

The Job Offer Letter, typically the first formal communication of employment terms to a prospective employee, often outlines information that will later be detailed in the NY Notice and Acknowledgement of Pay Rate form, such as salary, schedule, and other compensation details. It is a precursor document that introduces the employee to terms that will be formally acknowledged in the pay rate form.

The Timesheet and Pay Stub documents, though utilized post-hiring and throughout the employment period, complement the information provided in the NY Notice and Acknowledgement of Pay Rate form. These documents detail the practical application of the pay rate, including hours worked, pay received, and deductions made, offering a continuous acknowledgment of the terms initially agreed upon.

The Equal Employment Opportunity (EEO) Self-Identification Form, while primarily focused on gathering demographic data for compliance with federal laws promoting employment equality, similarly requires active participation and acknowledgment from the employee, much like the NY Notice and Acknowledgement of Pay Rate form. Both forms play a role in employing entities' efforts to adhere to legal standards and protect employee rights.

Dos and Don'ts

When filling out the New York Notice and Acknowledgement of Pay Rate form, there are several dos and don'ts that employees and employers should bear in mind to ensure that the process is completed properly and in compliance with New York State Labor Law.

Do:

  1. Review all the information carefully to ensure accuracy. This includes employer information, rate of pay, allowances, and the regular payday.
  2. Ensure that the form is provided in the primary language of the employee. If the Department of Labor does not offer a form in the employee's primary language, it must be noted on the form.
  3. Sign and date the form as acknowledgment of having received and understood the terms of pay rate and payday.
  4. Keep a signed copy of the form for personal records. Employees should receive a copy, and employers are required to keep the original for six years.

Don't:

  1. Overlook the section about overtime pay rates. It's crucial to ensure that the overtime rate is at least 1½ times the regular rate of pay, in accordance with state law.
  2. Fill out the form in haste without verifying all the details, especially the pay rate and any allowances such as tips, meals, or lodging.
  3. Forget to check the correct box indicating if the notice has been given at hiring, before a change in pay, allowances, or payday.
  4. Ignore the requirement to indicate the employee's primary language and ensure the form is provided in that language, if available.

Attention to these details will help both employees and employers navigate the requirements of the New York State Labor Law effectively, ensuring a transparent and compliant pay rate acknowledgment process.

Misconceptions

There are several misconceptions surrounding the Notice and Acknowledgement of Pay Rate form in New York; these encompass misunderstandings about its purpose, requirements, and implications for both employees and employers.

  • Misconception 1: The notice is only necessary at the time of hiring.
  • This belief misinterprets the form's flexibility and requirements under law. While it's critical to present this notice at hiring, the law also mandates that it be provided before any change in pay rate, allowances, or payday. This ensures continuous transparency in the employment relationship, safeguarding employees' rights to be fully informed about their compensation.

  • Misconception 2: The form is only for hourly employees.
  • The title "Notice for Hourly Rate Employees" might contribute to this misunderstanding, but in reality, the scope of the law covers a broader range of pay arrangements. Employers are required to provide a similar notice for employees salaried, paid by commission, or other non-hourly compensation structures, ensuring all workers are informed about their pay rate and payday in a manner that complies with New York State Labor Law.

  • Misconception 3: English is the only language requirement for the form.
  • While the provided excerpt mentions the Notice given in English, there's a common misconception that this fulfills all legal obligations. However, the law mandates that this notice be provided in the employee's primary language if available in that language from the Department of Labor. This requirement underscores the importance of accessibility and understanding for all employees, irrespective of their primary language.

  • Misconception 4: Employers do not need to keep a signed copy.
  • A critical but often overlooked requirement is that employers must retain the original signed notice for six years. This stipulation serves as a safeguard for both parties, providing tangible proof of compliance and understanding of the pay agreement. This archival responsibility ensures that documentation is available for reference in the event of disputes or audits.

Addressing these misconceptions is crucial for maintaining compliant and transparent employment practices in New York, emphasizing the importance of understanding both the letter and the spirit of the law regarding employee compensation and communication.

Key takeaways

Understanding the NY Notice and Acknowledgement of Pay Rate form is crucial for both employers and employees in New York State. This document ensures transparency and mutual understanding regarding payment terms between the two parties. Here are key takeaways:

  • It is mandated by Section 195.1 of the New York State Labor Law for the employer to provide this notice to employees at the time of hiring and before any changes in pay rate, allowances, or payday.
  • The form includes detailed information about the employer, such as the name, whether there is a Doing Business As (DBA) name, FEIN (optional), physical and mailing addresses, and phone number.
  • Employees are informed of their regular rate of pay, the pay period (e.g., weekly, bi-weekly, or other), and their overtime pay rate, which must be at least 1.5 times their standard hourly wage.
  • Any allowances that are part of the compensation package, such as tips, meals, or lodging, must be clearly itemized in the notice.
  • A regular payday must be established and communicated to the employee through this form.
  • The notice includes an employee acknowledgement section that confirms they have been informed of their pay rate, overtime compensation, allowances, and regular payday. Employees are also asked to identify their primary language.
  • This document requires the signature of both the employee and a preparer, who must also provide their name and title.
  • The employer is responsible for ensuring the employee receives a signed copy of this notice, and the original must be retained by the employer for six years.
  • Additionally, the notice contains a reminder that it is unlawful for employees to be paid less based on sex for equal work and that employees have the right to discuss wages with their coworkers.

Proper completion and handling of the Notice and Acknowledgement of Pay Rate form are not only legal requirements but also promote a transparent and fair work environment. This document serves as a fundamental tool in protecting both the employee's and employer's rights and clarifies key aspects of the employment agreement regarding compensation.

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