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Employee identification number

Ls54c form 2026

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The document is a Notice and Acknowledgement of Pay Rate and Payday for hourly rate employees in New York State, as required by Section 195.1 of the Labor Law. It outlines the employee's pay rate, allowances, regular payday, and overtime pay rate. The employee acknowledges receipt of this information and confirms their primary language. The document emphasizes the legality of equal pay for equal work and prohibits employers from restricting wage discussions among employees.

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Click ‘Get Form’ to open the ls54c form in the editor.
Begin by filling in the Employer Information section. Enter the employer's name and any Doing Business As (DBA) names if applicable.
In the Employee’s rate of pay section, specify the hourly wage. If there are allowances such as tips or meals, indicate those amounts as well.
Complete the Regular payday section by selecting how often employees will be paid: weekly, bi-weekly, or other.
Fill in the Overtime Pay Rate field, ensuring it meets legal requirements of at least 1½ times the regular rate.
In the Employee Acknowledgement section, check the appropriate box regarding language preference and provide your signature along with your printed name.
Finally, ensure that all required fields are completed before saving or exporting your filled form for distribution.

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