Notice and Acknowledgement of Pay Rate and Payday/???????? Under Section 195.1 of the New York State Labor Law/???????195.1 ?? Notice for Hourly Rate Employees. Notice and Acknowledgement of Pay Rate and Payday/???????? Under Section 195.1 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling in the Employer Information section. Enter the employer's name, DBA name if applicable, and FEIN (optional).
3. In the Employee’s Pay Rate section, specify the hourly pay rate clearly. Ensure this is accurate as it reflects your compensation.
4. Indicate any allowances taken such as tips, meals, or lodging. If none apply, select 'None'.
5. Fill in the Regular payday field to indicate how often you will be paid (weekly, bi-weekly, etc.).
6. Complete the Overtime Pay Rate section with the appropriate amount per hour. Remember that this must meet legal requirements.
7. In the Employee Acknowledgement section, confirm receipt of this notice by signing and dating it.

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