Store Manager Assistant
Resume:
*. Employee Acknowledgement : On this day I have been notified
of my pay rate, overtime rate (if eligible), allowances, and designated pay day on the date given below. I told my employer what my primary language is.
Check one:
I have been given this pay notice in English because it is my primary language.
My primary language is . I have been given
this pay notice in English only, because the Department of Labor does not yet offer a pay notice form in my primary language.
Print Employee Name
Employee Signature
Date
LISANNE ELLISON assistant store manager
Preparer's Name and Title
The employee must receive a signed copy of this form. The employer must keep the original for 6 years.
Please note: It is unlawful for an employee to be paid less than an employee of the opposite sex for equal work. Employers also may not prohibit employees from discussing wages with their co- workers.
3. Employee's rate of pay :
$ 15.00 per hour
4. Allowances taken :
None
Tips per hour
Meals per meal
Lodging
Other
5. Regular payday : Thursday
6. Pay is :
Weekly
Bi-weekly
Other
7. Overtime Pay Rate :
$ 22.50 per hour (This must be at least 1 times
the worker's regular rate with few exceptions.)
Employer Signature :
Notice and Acknowledgement of Pay Rate and Payday
Under Section 195.1 of the New York State Labor Law Notice for Hourly Rate Employees
1. Employer Information
Name:
GSL CONDUIT FOOD
Doing Business As (DBA) Name(s):
McDonald's
FEIN (optional):
11-3274368
Physical Address:
221-12 S Conduit Ave, Springfield Gardens, NY 11413, USA Mailing Address:
221-12 S Conduit Ave, Springfield Gardens, NY 11413, USA Phone :
2. Notice given :
At hiring
Before a change in pay rate(s), allowances claimed or payday LS 54 (09/22)
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