Ls 54 Form PDF Details

If you are a business owner, then you know that there are many different forms and applications that you need to file in order to keep your business running smoothly. One such form is the Ls 54 form. This form is used to apply for an exemption from the Missouri sales and use tax. If you are eligible for this exemption, then filing the Ls 54 form can save you a lot of money on your taxes. In this article, we will explain what the Ls 54 form is, and we will give you some tips on how to file it correctly.

Below is the information about the PDF you were seeking to fill out. It will tell you the time you will require to finish ls 54 form, what fields you will have to fill in, and so forth.

Form NameLs 54 Form
Form Length1 pages
Fillable fields0
Avg. time to fill out15 sec
Other namesnys ls54, ls 54 form 2020 fillable, ls 54 form, notice and acknowledgement of pay rate and payday fillable 2021

Form Preview Example

1. Employer Information


Doing Business As (DBA) Name(s):

FEIN (optional):

Physical Address:

Mailing Address:


2. Notice given:

At hiring

Before a change in pay rate(s), allowances claimed or payday

LS 54 (02/15)

Notice and Acknowledgement of Pay Rate and Payday Under Section 195.1 of the New York State Labor Law

Notice for Hourly Rate Employees

3. Employee’s rate of pay:





per hour

4. Allowances taken:










per hour






per meal



5. Regular payday:

6. Pay is:




7. Overtime Pay Rate:

$per hour (This must be at least 1½ times the worker’s regular rate with few exceptions.)

8. Employee Acknowledgement:

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.

Check one:

I have been given this pay notice in English

because it is my primary language.


My primary language is

. 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.

Print Employee Name

Employee Signature


Preparer’s Name and Title

The employee must receive a signed copy of this form. The employer must keep the original for 6 years.

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