Notice and Acknowledgement of Pay Rate and Payday - Notice for Employees Paid a Weekly Rate or a Sal 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering the Employer Information. Fill in the name, Doing Business As (DBA) name(s), FEIN (if applicable), physical address, and mailing address.
3. Next, specify the Employee’s Pay Rate. Enter the amount and indicate whether it is per hour or another time frame. Also, specify the weekly hours for which this rate applies.
4. Indicate any allowances taken by checking the appropriate boxes for tips, meals, lodging, or other allowances.
5. Fill in the Regular payday information and provide a contact phone number.
6. Select how often pay is distributed: weekly, bi-weekly, or other.
7. Enter the Overtime Pay Rate ensuring it meets legal requirements of at least 1½ times the regular rate.
8. In the Employee Acknowledgement section, ensure that employees confirm their understanding of their pay details and primary language preferences. Collect signatures and dates as required.

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