Ls425 form 2025

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34 votes

The document is a claim form for unpaid wage supplements issued by the New York State Department of Labor, Division of Labor Standards. It requires claimants to provide personal information, details about their employment, and specifics regarding the unpaid benefits they are claiming, such as holiday pay, vacation pay, and health insurance. The form also includes sections for the claimant to affirm the truthfulness of their statements and authorize the Commissioner of Labor to process any payments due.

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Versions	Form popularity	Fillable & printable
2013	4.8 Satisfied (34 Votes)

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