Get NY LS 52 2009-2024

Labor Law Section 195 1 Notice and Acknowledgement of Wage Rate and Designated Payday Hourly Rate Plus Overtime Employer Company Name Name FEIN Street address Apt. City City State State Zip Zip Phone - Preparer s Name Preparer s Title Your rate of pay per hour. Your overtime rate of pay per hour. Designated pay day I hereby certify that I have read the above and the information contained in this form is true and accurate to the best of my knowledge and belief* Any false statements knowingly made are punishable as a class A misdemeanor Section 210. 45 of the New York State Penal Law. Preparer s Signature General Statement Regarding Overtime Pay in New York Almost all employees in New York must be paid overtime wages of 1 times their regular rate of pay for all hours worked over 40 per workweek. A very limited number of specific categories of employees are covered by overtime at a lower overtime rate or not at all* I hereby acknowledge that I have been notified of my wage rate overtime rate and designated pay day on the date set forth below. Employee s Signature A duplicate signed copy of this form is to be provided to the employee. Original must be kept by the employer. City City State State Zip Zip Phone - Preparer s Name Preparer s Title Your rate of pay per hour. Your overtime rate of pay per hour. Designated pay day I hereby certify that I have read the above and the information contained in this form is true and accurate to the best of my knowledge and belief* Any false statements knowingly made are punishable as a class A misdemeanor Section 210. Designated pay day I hereby certify that I have read the above and the information contained in this form is true and accurate to the best of my knowledge and belief* Any false statements knowingly made are punishable as a class A misdemeanor Section 210. 45 of the New York State Penal Law. Preparer s Signature General Statement Regarding Overtime Pay in New York Almost all employees in New York must be paid overtime wages of 1 times their regular rate of pay for all hours worked over 40 per workweek. 45 of the New York State Penal Law. Preparer s Signature General Statement Regarding Overtime Pay in New York Almost all employees in New York must be paid overtime wages of 1 times their regular rate of pay for all hours worked over 40 per workweek. A very limited number of specific categories of employees are covered by overtime at a lower overtime rate or not at all* I hereby acknowledge that I have been notified of my wage rate overtime rate and designated pay day on the date set forth below. A very limited number of specific categories of employees are covered by overtime at a lower overtime rate or not at all* I hereby acknowledge that I have been notified of my wage rate overtime rate and designated pay day on the date set forth below. Employee s Signature A duplicate signed copy of this form is to be provided to the employee. Original must be kept by the employer. City City State State Zip Zip Phone - Preparer s Name Preparer s Title Your rate of pay per hour. Your overtime rate of pay per hour. Designated pay day I hereby certify that I have read the above and the information contained in this form is true and accurate to the best of my knowledge and belief* Any false statements knowingly made are punishable as a class A misdemeanor Section 210. 45 of the New York State Penal Law. Preparer s Signature General Statement Regarding Overtime Pay in New York Almost all employees in New York must be paid overtime wages of 1 times their regular rate of pay for all hours worked over 40 per workweek. .