What Form IA 12.3 Is For
The New York State Record of Employment (Form IA 12.3) is an official separation notice that employers must provide to workers when they leave employment. This form serves as written documentation that informs employees of their right to apply for Unemployment Insurance (UI) benefits with the New York State Department of Labor. The form includes essential employer information—such as the employer's name, New York State Employer Registration Number, Federal Employer Identification Number, and the address where payroll records are maintained—that helps the Unemployment Insurance Division process benefit claims accurately and ensures proper experience rating charges to employer accounts.
Form IA 12.3 acts as a certificate demonstrating that the employee's job was covered under New York's Unemployment Insurance system. However, receiving this form does not guarantee eligibility for benefits; the UI Claims Center determines actual qualification based on statutory requirements. The form also provides comprehensive instructions on how to file an unemployment claim, what documentation employees need, and contact information for the state's unemployment system.
When You’d Use Form IA 12.3
Situations That Require the Form
Employers must complete and provide Form IA 12.3 at the time of each employment separation, regardless of the reason or duration. Specifically, you must give this form to employees who are:
- Permanently, indefinitely, or temporarily laid off
- Discharged or terminated for any reason
- Voluntarily quit or resign
- Experience a reduction in hours to 30 or fewer per week
- Have any other interruption of continued employment that results in total or partial unemployment
The requirement applies even when employees voluntarily terminate their employment. The law does not distinguish between voluntary and involuntary separations—all employees going off the payroll must receive the notice. Employers should provide the form immediately upon separation, documenting the date it was given to the employee on the form itself.
Late or Corrected Situations
There is no specific "amended" version of Form IA 12.3. If employer information changes after separation (such as a business address or registration number correction), employers should communicate updates directly to the Department of Labor using appropriate change-of-information forms rather than reissuing Form IA 12.3. If an employer fails to provide the form at the time of separation, they should provide it as soon as the oversight is discovered, though late provision may affect the employer's experience rating if benefit claims are delayed.
Key Rules or Details for This Form
Mandatory Compliance
Every employer liable for Unemployment Insurance contributions under New York Labor Law Article 18 must provide Form IA 12.3. This includes general business employers, nonprofit organizations, governmental entities, household employers of domestic service workers (though they are exempt from posting workplace notices), and virtually all other employer categories. The requirement is statutory under Section 590 of the New York Labor Law, which was expanded in 2023 to include partial unemployment situations.
Partial Unemployment Threshold
Employees become potentially eligible for partial unemployment benefits when they work 30 hours or fewer in a week OR earn less than the maximum benefit rate in a week. As of October 2025, the maximum benefit rate is $869 per week. Employers must provide Form IA 12.3 when employer-initiated actions (such as hour reductions) trigger these thresholds, even if the employee remains on the payroll.
Required Information
The form must include:
- Employer’s legal name
- New York State Employer Registration Number
- Federal Employer Identification Number (FEIN)
- Complete payroll records address
Employers may optionally include internal identifiers such as payroll or clock numbers and location codes. The employee must also complete their portion, providing their name and Social Security number.
Approved Format
Employers must use Form IA 12.3 as furnished or approved by the New York State Department of Labor. Using substitute forms or custom separation notices does not satisfy the legal requirement unless approved.
Exceptions
- Shared Work Program participants do not require the form for covered reductions
- Educational institutions with “reasonable assurance” do not need to issue the form between academic periods
Step-by-Step (High Level)
Step 1: Determine if Notice is Required
Evaluate whether the employment separation or hour reduction triggers the Form IA 12.3 requirement.
Step 2: Obtain the Current Form
Download the most recent version or request copies from the Department of Labor.
Step 3: Complete the Employer Section
Fill in all required employer information accurately, including:
- Legal business name
- NY Employer Registration Number
- FEIN
- Payroll records address
Step 4: Document the Date and Provide to Employee
Record the date and provide the form at the time of separation or hour reduction.
Step 5: Have Employee Complete Their Section
Ensure the employee fills out their name and Social Security number.
Step 6: Maintain Records
Keep a copy or proof of delivery for compliance and audit purposes.
Common Mistakes and How to Avoid Them
Mistake 1: Not Providing the Form for Voluntary Resignations
Solution: Provide the form for ALL separations regardless of reason.
Mistake 2: Overlooking Partial Unemployment Situations
Solution: Monitor hours and earnings weekly to catch eligibility thresholds.
Mistake 3: Using Outdated or Custom Forms
Solution: Always use the latest official version from the Department of Labor.
Mistake 4: Incomplete or Incorrect Employer Information
Solution: Use a verified template with accurate employer data.
Mistake 5: Late or Missing Form Provision
Solution: Integrate the form into standard separation workflows.
Mistake 6: Assuming Household Employers Are Exempt
Solution: Provide the form even for domestic workers.
What Happens After You File
If the Employee Files a UI Claim
You will receive a Notice of Potential Charges (Form LO 400) and have 10 days to respond.
Experience Rating Charges
Your account may be charged if benefits are approved, affecting future UI rates.
Right to Contest
You can contest eligibility based on factors like misconduct or voluntary resignation.
If You Disagree with a Determination
You have 30 days to request a hearing with an Administrative Law Judge.
No Claim Filed
No further action occurs beyond recordkeeping.
FAQs
Do I need to provide Form IA 12.3 if an employee is only temporarily laid off for a few days?
Yes. The law applies regardless of the duration of the separation, even for short-term layoffs.
Can I use my payroll company's custom separation notice instead of Form IA 12.3?
No. Only official or approved forms meet legal requirements.
What if I reduce an employee's hours from 40 to 35 per week, but they still earn more than $869 per week?
You do not need to provide the form unless hours drop to 30 or below or earnings fall below the threshold.
I forgot to give an employee Form IA 12.3 when they quit two months ago. What should I do?
Provide the form immediately and respond to any notices from the Department of Labor.
Are nonprofit organizations and government agencies required to provide Form IA 12.3?
Yes. All liable employers must comply regardless of structure.
If I provide reasonable assurance to a school employee, do I still need to give the form?
No. Reasonable assurance removes the requirement between academic periods.
Does Form IA 12.3 guarantee unemployment benefits?
No. It only informs the employee of their right to apply. Eligibility is determined separately.
