Notice and Acknowledgment of Pay Rate and Payday

New York State — Wage Theft Prevention Act (Labor Law §195(1))

⚠ This notice must be provided to each employee at time of hire (in English AND the employee's primary language if different). Retain signed copy for 6 years.

Employer Name2nd Nature Park LLC
DBA (Doing Business As)2nd Nature Park
Employer Address
Employer Phone
Employer EIN
Employee Name
Rate of Pay$ per hour
Overtime Rate$ per hour (1.5× regular rate for hours over 40/week)
Allowances Taken None Tips Meals Lodging
Regular Payday Bi-weekly (every other Friday) Weekly (every Friday) Other:
Pay Method Direct Deposit Check
Effective Date of Hire
Job Title / Duties
Front Desk Instructor Lead Instructor Park Monitor Manager
Customer service, check-in, lesson instruction, party hosting, equipment rentals, park monitoring, retail shop, opening/closing checklists, light cleaning. (Specific duties may vary.)
Regular Work Schedule
Hours may vary by season, party bookings, and special events.
Workers' Comp Carrier
Employee Acknowledgment: I acknowledge that I received this notice on or before my first day of work. I have been informed of my rate of pay, overtime rate, payday, and employer information as required under NY Labor Law §195(1). I understand that this notice is also available to me in my primary language upon request.
Employee signature: Date:
Print name:
Primary language (if not English):
Employer signature: Date:
Print name: Title:
NY Wage Theft Prevention Act — key requirements:
• Employer must provide this notice at time of hire in English and the employee's primary language.
• Employee must sign and receive a copy. Employer retains signed original for 6 years.
• If pay rate changes, employer must provide 7 days advance written notice (or with next paycheck for increases).
• Employer must also provide a wage statement (pay stub) with each payment showing hours, rates, deductions, and dates.
• Failure to comply: $50/day penalty per employee (up to $5,000) plus potential civil liability.

At-Will Employment: Employment with 2nd Nature Park LLC is "at-will." Either party may end the employment relationship at any time, for any lawful reason, with or without cause or notice. This notice does not constitute an employment contract.
2nd Nature Park · Peekskill, NY · info@2ntr.com
Form template adapted from NY DOL §195(1). For official forms: dol.ny.gov/wage-theft-prevention-act