NY Wage Theft Prevention Form

Notice and acknowledgment of pay rate and payday under section 195.1 of the new york state labor law.

Notice for Employees Paid Salary for Varying Hours, Day Rate, Piece Rate, Flat Rate or Other Non-Hourly Pay.

PRODUCER - Please note copies of the completed and signed forms must be distributed: One copy to the employee, one copy to Extreme Reach Talent with other employment documents, and retain a copy for your records.

Extreme Reach Talent is the employer of record for the sole purposes of withholding and remitting employment taxes, providing workers’ compensation insurance and facilitating unemployment benefit claims.


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