DOL Form LS-802 is the New York State Department of Labor’s Pay Notice and Acknowledgement for Hospitality Industry form, used by employers to give tipped workers written notice of their pay rate, tip credit, allowances, and overtime rate before work begins, as required by the New York Wage Theft Prevention Act. Filling it out correctly protects the employer from steep penalties and gives the worker a clear, signed record of every pay term that controls the paycheck.
Wage notice rules under New York Labor Law §195.1 and the Hospitality Industry Wage Order at 12 NYCRR §146 require this notice at hire, before any change in pay, and in both English and the worker’s primary language. The federal layer comes from the Fair Labor Standards Act tip credit rules at 29 U.S.C. §203(m) and the U.S. Department of Labor’s Wage and Hour Division Fact Sheet #15. When the LS-802 is wrong, missing, or unsigned, the employer can lose the entire tip credit and owe full minimum wage plus liquidated damages.
A 2024 New York Attorney General report found that wage theft costs New York workers more than $1 billion each year, and tipped restaurant workers file the largest share of those claims. That single statistic is why every line on the LS-802 matters.
Here is what you will learn from this guide:
- 📝 How to fill out every line of DOL Form LS-802 without triggering a wage claim
- 💵 How the tip credit works under both NY 12 NYCRR §146-1.3 and the federal FLSA
- ⚖️ The penalties for missing, late, or wrong notices under the Wage Theft Prevention Act
- 🍽️ Real examples for servers, bartenders, food runners, delivery workers, and banquet staff
- 🚫 The most common LS-802 mistakes and how to fix them before payroll runs
What Form LS-802 Is and Who Must Use It
Form LS-802 is the hospitality-industry version of the New York wage notice. It is the only LS-series notice that builds in the tip credit, meal credit, and uniform allowance boxes that the Hospitality Industry Wage Order demands. Restaurants, hotels, catering halls, diners, coffee shops, and food trucks all fall under the wage order, so they must use LS-802 instead of the general LS-54 or LS-59 forms.
The plain-English meaning is simple. If your business serves food or drink, or provides lodging, and any worker earns tips, you must give that worker LS-802 on or before the first day of work, and again any time the rate, tip credit, or allowance changes.
The consequence of skipping it is severe. Under NY Labor Law §198(1-b), the worker can collect $50 per workday, capped at $5,000, plus attorney fees, plus liquidated damages, plus the lost tip credit recomputed at full minimum wage.
A real-world example helps. Maria opens a small Brooklyn café and hires Diego as a barista who also pools tips. She forgets to hand him the LS-802. Six months later Diego files a complaint, and Maria owes the full $15.50 NYC minimum wage for every hour Diego worked, not the tipped rate, plus the $50-per-day notice penalty.
A common misconception is that a verbal pay agreement or a handbook acknowledgement is enough. It is not. The statute requires the specific LS-802 form or an employer-built notice that contains every element the DOL prescribes, signed by the worker, and kept for six years.
Who counts as a “tipped worker” under LS-802
A tipped worker under 12 NYCRR §146-3.4 is a food service worker who customarily and regularly receives tips, or a service employee in a resort or hotel who receives tips at or above the weekly threshold set by the wage order. Bussers, runners, sommeliers, and barbacks are usually food service workers. Banquet captains and bell staff are usually service employees.
The federal definition is narrower. Under 29 U.S.C. §203(t), a tipped employee is one who customarily and regularly receives more than $30 a month in tips. New York’s threshold is stricter, so New York employers must apply the state rule.
The consequence of misclassifying a non-tipped worker as tipped is the loss of the tip credit for that worker and a possible dual-jobs violation under the DOL 80/20/30 rule. Anna, a host who also runs food, cannot be paid the tipped rate because hosting is non-tipped work.
Where to download the current LS-802
The official, fillable PDF lives on the NY DOL forms page. Always pull a fresh copy each January because the tipped, overtime, meal, and lodging credit numbers change every year on December 31. Using last year’s form is one of the fastest ways to lose the tip credit.
The DOL also publishes the form in Spanish, Chinese, Korean, Polish, Russian, Haitian Creole, and Bengali. You must give the notice in the worker’s primary language if the DOL publishes a translation in that language. Skipping the translation is a standalone violation, even if the English copy is perfect.
Line-by-Line: How to Fill Out LS-802
The current LS-802 has eleven numbered sections. Each one ties to a specific provision in NY Labor Law §195.1 or 12 NYCRR §146. Skipping any field can void the tip credit, so go slowly and double-check the math before the worker signs.
Section 1: Employer Information
Enter the legal business name, any doing-business-as (DBA) name, the physical address of the worksite, the mailing address if different, and the main phone number. The legal name must match what is on file with the New York Department of State. A mismatch here is a WTPA §195.1 violation on its own.
The consequence of using only a DBA is that workers cannot serve a wage claim on the right entity, which the DOL treats as a notice failure. Jamal runs “Brooklyn Slice” but his LLC is “Atlantic Pizza Holdings LLC.” Both names belong on the form, with the LLC listed first.
A common misconception is that listing the franchise brand is enough. It is not. The franchisee LLC is the legal employer and must be named.
Section 2: Employee Information
Fill in the worker’s full legal name, start date, and primary language. The primary language box drives whether you must hand over a translated copy. Mark “English” only if the worker confirms English in writing.
The consequence of guessing the language is a separate WTPA violation. Wei, hired as a dim-sum server, speaks Mandarin at home; the employer must give her both the English LS-802 and the Chinese LS-802.
A common misconception is that bilingual ability removes the duty. It does not. The worker’s primary language controls.
Section 3: Pay Rate
List the regular hourly cash wage the employer pays before tips. For 2026, the lowest legal cash wage in NYC, Long Island, and Westchester for food service workers is $11.00, and $10.35 for the rest of the state, per the NY DOL minimum wage schedule. Service employees use a different floor.
The consequence of writing a number below the wage-order floor is automatic loss of the tip credit and a §198 penalty. Carlos, listed at $9.00 an hour as a Manhattan server, instantly converts to a full-minimum-wage claim at $16.50 for every hour worked.
A common misconception is that “the tipped rate is whatever I want as long as tips make up the difference.” That is wrong. The cash floor is fixed by the wage order.
Section 4: Tip Credit Claimed
Write the dollar amount of the tip credit the employer is taking per hour. In NYC for 2026, the maximum food-service tip credit is $5.50, bringing the worker to the full $16.50 minimum wage when combined with the $11.00 cash wage.
The consequence of taking a tip credit larger than the wage order allows is full disgorgement under 12 NYCRR §146-1.3. Priya, a Queens bartender, sees a $6.50 tip credit on her LS-802; the employer owes her the entire credit back plus liquidated damages.
A common misconception is that tip pooling lets the employer claim a bigger credit. It does not. The credit ceiling is per worker, not per pool.
Section 5: Overtime Rate
Compute overtime at 1.5 times the full minimum wage, then subtract the same tip credit, per 12 NYCRR §146-1.4. For an NYC food service worker in 2026, that is $24.75 minus $5.50 = $19.25.
The consequence of basing overtime on the cash wage instead of the full minimum wage is one of the most common wage-theft findings the DOL issues. Tomás, paid $16.50 overtime by mistake, is owed the $2.75 difference for every overtime hour over six years.
A common misconception is that salaried hospitality managers do not get overtime. They do, unless they meet the federal executive exemption.
Section 6: Allowances Claimed
Check the boxes for any meal, lodging, or uniform-maintenance allowance the employer is taking. List the per-meal, per-week, or per-day dollar amount. The 2026 meal credit in NYC is $3.95 per meal, per 12 NYCRR §146-1.9.
The consequence of taking an undisclosed allowance is full repayment plus penalties. Sofia worked a banquet hall that quietly deducted $25 a week for uniform laundering without listing it on her LS-802; she recovered every dollar plus liquidated damages.
A common misconception is that providing a “free” staff meal lets the employer always take the credit. It does not. The meal must meet the adequate and varied test in §146-3.7.
Section 7: Pay Frequency
Hospitality workers are manual workers under NY Labor Law §190(4), so they must be paid weekly and within seven calendar days of the end of the work week. Mark the weekly box and list the regular payday.
The consequence of biweekly pay for manual workers is a Vega v. CM & Associates liquidated-damages claim equal to the late wages, even if every dollar was eventually paid.
A common misconception is that direct deposit cures late pay. It does not. The deposit must clear within the seven-day window.
Section 8: Pay Day
List the specific weekday wages are paid, such as “every Friday.” Vague entries like “weekly” without a day are treated as missing.
Section 9: Acknowledgment and Signature
The worker must sign and date the form before starting work, and check the box confirming the language version received. The employer’s representative also signs.
The consequence of a missing signature is the same as a missing form. Elena’s LS-802 was complete but unsigned; the DOL treated it as never given.
A common misconception is that an electronic signature is invalid. It is valid if it complies with the NY Electronic Signatures and Records Act.
Section 10: Recordkeeping
Keep the signed original for six years under 12 NYCRR §146-2.1. Scanned copies are fine if they are legible and tamper-evident.
Section 11: Re-Issuance Triggers
Reissue LS-802 any time the rate, tip credit, allowance, pay day, or legal employer name changes. New York repealed the annual reissuance rule in 2014, but the change-trigger rule still applies.
Three Real-World LS-802 Scenarios
Each scenario below shows a single decision and the legal consequence under 12 NYCRR §146 and the FLSA.
Scenario A: NYC Server Working Dual Jobs
| Employer Decision | Legal Consequence |
|---|---|
| Pays Diego the $11.00 tipped rate for 6 hours of serving and 3 hours of cleaning the dining room before open | Loses the tip credit for the 3 cleaning hours under the 80/20/30 rule; owes full $16.50 for those hours plus liquidated damages |
| Lists “Server/Cleaner” on the LS-802 with two separate rates | Preserves the tip credit for serving hours and avoids a dual-jobs violation |
| Refuses to issue a new LS-802 when Diego is promoted to bartender at $12.00 cash wage | Triggers a WTPA §195.1 violation at $50 per workday up to $5,000 |
Scenario B: Long Island Banquet Hall with Service Charge
| Employer Decision | Legal Consequence |
|---|---|
| Charges a 22% “administrative fee” and keeps it without disclosure | Violates Samiento v. World Yacht Inc., turning the fee into a gratuity owed to staff |
| Lists the fee on the LS-802 and on the customer contract as non-gratuity in plain language | Allows the employer to retain the fee under §146-2.18 |
| Pools the fee with tips and still claims a tip credit | Loses the entire tip credit and owes full minimum wage plus liquidated damages |
Scenario C: Upstate Diner Hiring a Bilingual Worker
| Employer Decision | Legal Consequence |
|---|---|
| Gives Anya, a Russian-speaking server, only the English LS-802 | Standalone WTPA violation even if every number is correct |
| Provides both the English and Russian LS-802 and has Anya check the language box | Full compliance with §195.1 |
| Uses the 2025 form with last year’s wage numbers | Loses the tip credit because the disclosed rate is below the 2026 floor |
Three Named Examples to Anchor the Rules
Maria Alvarez runs a 12-seat ramen counter in Astoria. She hires Kenji Watanabe as a counter server. Maria fills out LS-802 with the $11.00 cash wage, $5.50 tip credit, and a $3.95 meal credit for the staff bowl. Kenji signs both English and Japanese copies. Six months later he leaves on good terms, and Maria’s records survive a routine DOL audit without a single finding.
Jerome Baptiste manages a Buffalo sports bar and hires Lena Petrov as a bartender. Jerome uses last year’s LS-802 with a $10.00 cash wage. The 2026 upstate floor is $10.35. When Lena complains, the DOL voids the tip credit and Jerome owes the full $15.50 minimum wage for every hour Lena worked, plus 100% liquidated damages under Labor Law §198.
Priya Shah owns a catering company in White Plains and hires Marcus Johnson as a banquet captain. Priya checks the service-employee box, lists the $13.75 cash wage, $2.75 tip credit, and notes the $135 weekly tip threshold under §146-1.3(b). Marcus’s signed LS-802 protects Priya when a customer’s 20% service charge dispute reaches the DOL.
Mistakes to Avoid
The mistakes below are the seven that cost New York hospitality employers the most money in DOL settlements and private litigation each year.
- Using the prior-year form. Wage rates change every December 31, and an outdated rate voids the tip credit.
- Skipping the primary-language translation. A perfect English form is still a violation if the worker’s primary language has a DOL translation.
- Listing the DBA only. The legal LLC or corporation must appear, or workers cannot serve claims correctly.
- Computing overtime on the cash wage. Overtime is 1.5 × full minimum wage − tip credit, never 1.5 × cash wage.
- Failing to reissue after a raise. Any change in pay terms triggers a new LS-802 under §195.1.
- Taking an undisclosed uniform-maintenance charge. Without box-check disclosure, the deduction is unlawful under §146-1.7.
- Paying biweekly. Manual workers must be paid weekly under §190(4); the Vega ruling makes late pay actionable.
Federal vs. New York Rules at a Glance
| Issue | Federal FLSA | New York |
|---|---|---|
| Tipped-employee threshold | More than $30/month in tips per 29 U.S.C. §203(t) | Customarily and regularly per §146-3.4 |
| Cash wage floor | $2.13/hour under FLSA §3(m) | $11.00 NYC food service for 2026 |
| Written wage notice | Not required by FLSA | Required at hire and at change under §195.1 |
| Penalty for missing notice | None federal | $50/day, capped at $5,000 under §198(1-b) |
| Pay frequency | No federal rule | Weekly for manual workers under §190(4) |
| Tip-pool rule | Back-of-house allowed only if no tip credit, per DOL 2021 Final Rule | Limited to those who customarily receive tips under §146-2.16 |
Do’s and Don’ts for Filling Out LS-802
The list below mirrors the most common audit findings from the NY DOL Division of Labor Standards.
- Do download a fresh form from the DOL forms page every January because the wage numbers change.
- Do confirm the worker’s primary language in writing before choosing the translation, since the wrong language is its own violation.
- Do list both the legal entity and the DBA so a wage claim reaches the right defendant.
- Do reissue the form within seven days of any rate or allowance change to preserve the tip credit.
- Do keep the signed original for six years under §146-2.1, because the statute of limitations runs that long.
- Don’t rely on a verbal promise; the WTPA requires a signed written notice on the LS-802 form.
- Don’t copy last year’s overtime rate; recompute it from the new minimum wage every year.
- Don’t lump the tip credit into a single “tipped wage” line; the form requires the cash wage and the credit on separate lines.
- Don’t take a meal credit for snacks; the meal must be adequate and varied under §146-3.7.
- Don’t assume an electronic acknowledgement is enough; it must comply with ESRA and be tied to the worker’s identity.
Pros and Cons of Using the Tip Credit on LS-802
Claiming a tip credit on the LS-802 is optional. Some employers skip it on purpose to simplify payroll and unlock broader tip pooling under the 2021 federal rule.
- Pro: Lower cash payroll cost because the credit reduces the cash wage owed by up to $5.50/hour in NYC.
- Pro: Aligns the worker’s incentives with service quality because tips drive most of the take-home pay.
- Pro: Allows tip-pool participation only among traditionally tipped staff, simplifying pool design.
- Pro: Reduces overtime cash outlay because overtime is also reduced by the tip credit.
- Pro: Standard practice in the industry, so workers expect and accept it.
- Con: One paperwork mistake voids the credit and triggers full minimum-wage liability under §146-1.3.
- Con: Triggers the 80/20/30 dual-jobs rule, which is hard to track in small kitchens.
- Con: Limits back-of-house tip pooling because credit-claiming employers cannot share with cooks or dishwashers.
- Con: Increases litigation risk; tipped-worker class actions are the largest category of New York wage suits.
- Con: Adds annual recompute work because rates and credits change every December 31.
Key Court Rulings Every Employer Should Know
Samiento v. World Yacht Inc., 10 N.Y.3d 70 (2008) holds that a mandatory service charge looks like a gratuity to a reasonable customer and must be paid to staff unless the employer clearly discloses the charge as non-gratuity. The LS-802 is the first place the disclosure should appear.
Vega v. CM & Associates Construction Management, 175 A.D.3d 1144 (1st Dep’t 2019) confirms that manual workers, including most hospitality staff, can sue for liquidated damages when paid late, even if eventually paid in full.
Marsh v. J. Alexander’s LLC, 905 F.3d 610 (9th Cir. 2018) shaped the 80/20 dual-jobs analysis later adopted in DOL Field Assistance Bulletin 2021-02. The ruling is why “side work” must be tracked on the LS-802 job description.
Restaurant Law Center v. DOL, 115 F.4th 396 (5th Cir. 2024) vacated the federal 80/20/30 rule for FLSA purposes, but New York employers still face the state-law equivalent under §146-2.9. The LS-802 should still flag side-work expectations.
Penalties, Statute of Limitations, and Defenses
Penalties under Labor Law §198(1-b) start at $50 per workday and cap at $5,000 per worker. Add 100% liquidated damages, 9% prejudgment interest, and attorney fees, and a single missing LS-802 can cost five figures per worker.
The statute of limitations under Labor Law §198(3) is six years, which is twice the FLSA’s three-year ceiling. That long window is why the DOL recordkeeping rule sets the same six-year retention period.
The only true safe harbor is the complete-and-timely-payment defense in §198(1-b), which requires the employer to prove every wage was paid on time, every notice was issued, and every record was kept. Courts read the defense narrowly, so the LS-802 paper trail is the foundation.
FAQs
Is DOL Form LS-802 required for every hospitality worker in New York?
Yes. Every food service worker, service employee, and non-tipped hospitality worker must receive LS-802 at hire and at any change in pay terms under NY Labor Law §195.1 and 12 NYCRR §146.
Do I have to give LS-802 in a language other than English?
Yes. If the worker’s primary language has a DOL translation, you must give that translated version along with the English copy, even if the worker also speaks English at work.
Can I use a digital signature on the LS-802?
Yes. Electronic signatures comply with the NY Electronic Signatures and Records Act when the system reliably identifies the signer and prevents tampering with the signed PDF.
Does the federal FLSA require a written wage notice like LS-802?
No. The FLSA requires posters and recordkeeping but no individual written wage notice; the LS-802 obligation comes from New York law and applies on top of federal rules.
Can I claim a tip credit if I do not give LS-802?
No. Without a properly completed and signed LS-802, the §146-1.3 tip credit is voided and the worker is owed the full minimum wage for every hour worked.
Must I reissue LS-802 every year?
No. New York eliminated the annual reissuance rule in 2014, but you must still reissue any time the rate, tip credit, allowance, or legal employer name changes under §195.1.
Can a service charge replace a tip on the LS-802?
No. Under Samiento v. World Yacht, a service charge belongs to the staff unless the employer clearly discloses on the LS-802 and customer contract that the charge is non-gratuity.
Does LS-802 cover delivery workers?
Yes. Food delivery workers in restaurants are food service workers under §146-3.4, so they get LS-802 with the proper tipped rate and the bicycle or vehicle expense disclosure.
Can I keep LS-802 records electronically?
Yes. Scanned or digitally signed copies satisfy the §146-2.1 six-year retention rule as long as the file is legible, tamper-evident, and produced quickly during a DOL audit.
Is the penalty for a missing LS-802 capped?
Yes. Labor Law §198(1-b) caps the notice penalty at $5,000 per worker, but liquidated damages, lost tip credit, interest, and attorney fees are uncapped and usually dwarf the notice penalty.
Do banquet halls and catering companies use LS-802?
Yes. Catering and banquet operations are hospitality employers under 12 NYCRR §146-3.1, so service employees there must receive LS-802 with the proper service-employee tipped rate.
Can workers waive their LS-802 rights?
No. Wage notice and tip-credit rights cannot be waived under Labor Law §663, and any agreement to waive them is void as against public policy.
Related reading
- How to Fill Out DOL Form LS-202 (w/Examples) + FAQs
- How to Fill Out DOL Form LS-207 (w/Examples) + FAQs
- How to Fill Out DOL Form LS-208 (w/Examples) + FAQs
- How to Fill Out DOL Form LS-272 (w/Examples) + FAQs
- How to Fill Out DOL Form LS-4 (w/Examples) + FAQs
- How to Fill Out DOL Form LS-426 (w/Examples) + FAQs