The LS-59 form in New York is the “Notice and Acknowledgement of Pay Rate and Payday” that employers must give overtime-exempt salaried employees at hire under Section 195.1 of the New York Labor Law. You fill in the pay rate, payday, and any wage allowances, the employee signs it, you give them a copy, and you keep the original for six years. Skipping it or filling it out sloppily exposes you to up to $5,000 per employee in statutory damages plus attorney’s fees.1New York State Senate. New York Labor Code 198 – Costs, Remedies
Who the LS-59 Is For
The LS-59 applies only to employees who are exempt from overtime, meaning salaried workers in executive, administrative, or professional roles. Hourly workers, salaried non-exempt staff, public-work employees, and farm laborers each have their own pay rate notice (LS 54, LS 55, LS 56, LS 57, LS 58, or LS 309). Using the wrong form number does not satisfy the notice requirement, so confirm the employee’s classification before filling anything in.
Download the Current Version
Pull a fresh copy of the LS-59 from the New York State Department of Labor. The fillable PDF lives at forms.labor.ny.gov, and the DOL also posts translated versions on its dedicated LS-59 page.2Department of Labor. Pay Rate Notice For Exempt Employees The current version is LS 59 (12/25). The Department updates the template periodically, so reusing an old printout can create problems in an audit.
Filling Out the Form
The LS-59 has eight sections. Work through them in order.
1. Employer Information
Enter your business’s full legal name, any DBA names, physical address, mailing address if different, and phone number. The FEIN field is optional. The statute requires the employer’s “main office or principal place of business,” so use your headquarters address rather than a specific work site unless they are the same.3New York State Senate. New York Code LAB – Notice and Record-Keeping Requirements
2. Notice Type
Check “At hiring” for a new employee. The other box is used later if you ever change the employee’s pay rate, allowances, or payday.
3. Pay Rate
State the rate and the basis. For most exempt employees this is a weekly or annual salary. Be specific: write “$1,275.50 per week” or “$66,300 per year,” not just “salary.” The employee needs to be able to check the number against their pay stub.4New York State Department of Labor. New York State Labor Law Section 195.1 Notice and Acknowledgement of Pay Rate and Payday
4. Allowances
If you claim any allowances toward the minimum wage (tips, meals, lodging, or otherwise), check the relevant box and enter the dollar amount. If you claim none, check “None.” For salaried exempt employees earning well above minimum wage this will almost always be “None,” but you still have to answer. A blank field is not the same as a checked “None” box, and an auditor may treat it as a deficient notice.5New York State Department of Labor. Notice of Pay Rate
5 and 6. Payday and Pay Frequency
Designate the regular payday, for example “every other Friday,” and check whether pay is weekly, biweekly, or another schedule. Exempt employees are typically non-manual workers, so biweekly or semimonthly pay is permissible.6Department of Labor. Frequency of Pay
7. Overtime Exemption
Because this is the exempt-employee version of the notice, the form includes a line for the specific exemption category (executive, administrative, professional, or other). The line is marked optional, but filling it in creates a clear record of why you classified the employee as exempt. That record helps if the classification is ever challenged.
8. Employee Acknowledgement
The employee prints their name, signs, and dates the form. The signature confirms they received notice of their pay rate, allowances, and payday, and that they identified their primary language to you. Only the employee signs; the employer does not.4New York State Department of Labor. New York State Labor Law Section 195.1 Notice and Acknowledgement of Pay Rate and Payday
Delivering the Notice and Getting a Signature
Hand the completed LS-59 to the employee at the time of hire, before they start working. The statute says “at the time of hiring,” and the Department of Labor interprets that to mean no later than the first day. Waiting until after the first paycheck starts the penalty clock.
Once the employee signs, give them a copy and keep the original. The form itself specifies that the employer retains the original and the employee receives a signed copy.4New York State Department of Labor. New York State Labor Law Section 195.1 Notice and Acknowledgement of Pay Rate and Payday
If the Employee Refuses to Sign
A refusal does not excuse the notice obligation. You must still provide the notice and note the refusal on your copy.7New York State Department of Labor. Wage Theft Prevention Act Frequently Asked Questions Write something like “Employee declined to sign; notice provided on [date]” and, if you can, have a witness sign. The point is to document delivery even without acknowledgement.
Language Requirements
You must provide the LS-59 in both English and the employee’s primary language whenever the Department of Labor has published a translation in that language.3New York State Senate. New York Code LAB – Notice and Record-Keeping Requirements If no translation exists for that language, the English version alone satisfies the requirement.
The DOL currently publishes the LS-59 in 18 languages, including Spanish, Chinese (Simplified), Russian, Haitian Creole, Bengali, Korean, Polish, Arabic, Italian, French, Urdu, and Yiddish, among others. The complete set is on the Department’s LS-59 download page.2Department of Labor. Pay Rate Notice For Exempt Employees When you provide a translated version, give the English copy alongside it and have the employee sign both.
When You Need to Issue a New LS-59
Any change to pay rate, allowances, or payday triggers a fresh notice before the change takes effect. Outside the hospitality industry, there is one carve-out: if the change is a pay increase and the new rate appears on the employee’s very next wage payment, you do not have to issue a separate written notice. A pay decrease always requires a new notice in advance.5New York State Department of Labor. Notice of Pay Rate
Record Retention
Keep the signed original LS-59 for at least six years. Both the statute and the form itself state this.3New York State Senate. New York Code LAB – Notice and Record-Keeping Requirements Store it with your other payroll records. Six years is also the window for an employee to bring a wage claim, so holding the signed notice that long gives you an affirmative defense if a former worker later disputes what they were told.
Penalties for Noncompliance
Fail to provide the LS-59 within ten business days of the employee’s first day, and the employee can sue for $50 per workday the violation continues, capped at $5,000, plus attorney’s fees and costs. The Labor Commissioner can pursue the same damages administratively.1New York State Senate. New York Labor Code 198 – Costs, Remedies
Two affirmative defenses exist: that you made complete and timely payment of all wages owed even though you failed to give the notice, or that you reasonably believed in good faith the notice was not required. Neither is a reliable shield. The form is simple enough that a good-faith mistake is hard to sell, and paying correct wages does not erase the separate notice duty.
Failing to maintain the required records, including signed pay rate notices, can also produce misdemeanor charges carrying a fine of $500 to $5,000 or up to one year of imprisonment. Repeat violations within six years escalate to a felony.