Ls55 Form PDF Details

In the complex sphere of labor laws, documentation serves as both a record and a safeguard. The LS55 form, or "Notice and Acknowledgement of Pay Rate and Payday Under Section 195.1 of the New York State Labor Law Notice for Multiple Hourly Rate Employees," is a cornerstone document in this domain. This form encompasses a broad array of vital information, starting with employer details including their business name, physical and mailing address, and optionally, their Federal Employer Identification Number (FEIN). It extends its utility by ensuring employees are adequately informed about their employment conditions – from rates of pay for different types of work or shifts, specified allowances such as tips, meals, and lodging, to the regularity of their payday. Notably, the form plays a pivotal role in clarifying the computation and notification of overtime rates, which must align with the legal requirement of being at least one and a half times the employee's average rate of pay, adjusting weekly based on hours worked at varying pay rates. Further strengthening its role, the LS55 mandates employee acknowledgment of receiving and understanding these details, including any notifications about changes in pay rate, allowances, or payday, thereby fostering transparency between employers and employees. Signed acknowledgments are to be kept by employers for six years, underscoring the form's importance in labor compliance and protection. Through these specifications, the LS55 form embodies a comprehensive approach to ensuring employees are well-informed about their pay structure and rights, which in turn supports clearer communication and compliance within the New York State labor framework.

QuestionAnswer
Form NameLs55 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesnew york state department of labor form ls55, ls55 spanish, ls55 form, ny state ls55 form

Form Preview Example

1. Employer Information

Name:

Doing Business As (DBA) name(s):

FEIN (optional):

Physical Address:

Mailing Address:

Phone:

2. Notice given:

At hiring

On or before February 1

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

Notice and Acknowledgement of Pay Rate and Payday

Under Section 195.1 of the New York State Labor Law

Notice for Multiple Hourly Rate Employees

3.Employee’s rate(s) of pay for each type of work or shift:

$_________per hour for ____________

$_________per hour for ____________

$_________per hour for ____________

4. Allowances taken:

None

Tips __________ per hour

Meals _________ per meal

Lodging _________

Other __________________________

5.Regular payday: ____________________

6.Pay is:

Weekly

Bi-weekly

Other

7.Overtime Pay Rate(s) for each type of work or shift:

This must be at least 1½ times the worker’s weighted average of the multiple rates of pay for the week, with few exceptions. The weighted average is the total regular pay divided by the total hours worked in the week. The overtime rate may vary from week to week depending on how many hours you worked at

each rate of pay. The overtime rate may vary from week to week.

8. Employee Acknowledgement:

On this day I have been notified of my pay rate, overtime rate (if eligible), allowances, and designated payday 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’s Name

Employee’s Signature

Date

Preparer’s Name and Title

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

LS 55 (4/12)

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1. To start off, once completing the ls55 form, start with the section that features the subsequent blanks:

department of labor wage form nyc ls 55 completion process explained (part 1)

2. Once your current task is complete, take the next step – fill out all of these fields - Overtime Pay Rates for each type, This must be at least times the, Notice given, At hiring, On or before February, Before a change in pay rate s, allowances claimed or payday, and Employees Signature Date Preparers with their corresponding information. Make sure to double check that everything has been entered correctly before continuing!

Before a change in pay rate s, allowances claimed or payday, and Overtime Pay Rates for each type inside department of labor wage form nyc ls 55

People generally get some points incorrect while completing Before a change in pay rate s in this area. Ensure you go over whatever you enter here.

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