Fillable Employee notice INDUSTRY DEPARTMENT OF LABOR AND (Minnesota)

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Employee notice INDUSTRY DEPARTMENT OF LABOR AND (Minnesota)

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DEPARTMENT
OF
LABOR
AND
INDUSTRY
Employee notice
1. Employee: Address:
Phone number: Email address:
Date employment began:
2. Legal name of employer: Main office/principal place of business address:
Phone number: Email address:
Operating name of employer (if different):
Mailing address (if different):
3. Employment status (exempt or non-exempt):
☐ Employee is exempt from: ☐ minimum wage ☐ overtime ☐ other provisions of Minnesota Statutes 177
Legal basis for exemption:
☐ Employee is non-exempt (entitled to overtime, minimum wage, other protections under Minn. Stat. 177)
4. Rate or rates of pay
Paid by: Hour ☐ Shift ☐ Day ☐ Week ☐ Salary ☐ Piece ☐ Commission ☐ Other method ☐
hours
Overtime is owed after:
Allowances claimed:
$ per meal for meal allowance (max = 60% of one hour of adult minimum wage per meal)
$ per day for lodging allowance (max = 75% of one hour of adult minimum wage per day) (or fair market value)
5. Leave benefits available:
☐ Sick leave ☐ Paid vacation ☐ Other paid time off
How benefits are accrued: Number of hours ________ or days ________
per ☐ year ☐ month ☐ per pay period ☐ per hours worked
Terms of use:
6. Deductions that may be made from employee’s pay and amounts:
7. Number of days in the pay period: Regularly scheduled payday:
Date employee will receive first payment of wages earned:
8. Other information relevant to this position:
I, the employee, have received a copy of this notice: ☐ Yes ☐ No
Employer signature Date Employee signature Date
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This document contains important information about your employment. Check the box at left to receive
this information in this language.
Translation providers approved by the Minnesota Department of Administration
Betmar Languages, Inc.
6260 Hwy. 65 N.E.
Minneapolis, MN 55432
763-572-9711
best@betmar.com
The Bridge World Language Center, Inc.
110 Second Street S., #308
Waite Park, MN 56387
320-259-9239
mini@bridgelanguage.com
Fox Translation Services
1152 Mae Street, #122
Hummelstown, PA 17033
866-369-1646 or 407-733-3720
dina@foxfoxcasemanagement.com
Global Translation and
Interpreter
913 E. Franklin Ave., #206
Minneapolis, MN 55404
612-722-1244
sandor@globaltranslations.com
Latin American Translators Network, Inc.
1720 Peachtree Street N.W., #532
Atlanta, GA 30309
800-943-5286, ext. 8641, translations@latn.com
800-943-5286, ext. 8620, idenis@latn.com
Latitude Prime, LLC
80 S. Eighth Street, #900
Minneapolis, MN 55402
888-341-9080, ext. 501
elle@latitude.com
Lingualinx Language Solutions,
Inc.
433 River Street, #6001
Troy, NY 12180
518-388-9000
abartlett@lingualinx.com
Prisma International, Inc.
1128 Harmon Place, #310
Minneapolis, MN 55403
612-349-3111
jromano@prisma.com
Swits, LTD
110 S. Third Street
Delavan, WI 53115
262-740-2590
translations@swits.us
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Employee notice INDUSTRY DEPARTMENT OF LABOR AND (Minnesota)

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Completed 4 August 2021

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