What Form IA 12.3 Is For
Form IA 12.3, Record of Employment, is an official New York State document that employers must provide to employees when they leave their job. This form serves as written proof that the employee worked for your business and that the employment was covered under New York State's Unemployment Insurance (UI) program. The form does not determine whether the employee qualifies for unemployment benefits—that determination is made by the New York State Department of Labor's UI Claims Center when the employee files a claim. Instead, Form IA 12.3 provides essential employer information that the separated employee needs when applying for unemployment insurance benefits, including the employer's name, New York State employer registration number, and the location where payroll records are maintained.
The form is required under New York State Labor Law and applies to all employers subject to unemployment insurance requirements, including business employers, nonprofit organizations, governmental entities, and household employers who pay at least $500 in cash wages during any calendar quarter. Employers can obtain blank Form IA 12.3 from the New York State Department of Labor by calling the Employer Hotline at 1-888-899-8810, visiting the department's website at www.labor.ny.gov, or writing to the department's Liability and Determination Section. Employers may also request approval to use an equivalent form that contains all required information.
When You’d Use Form IA 12.3
Standard Use Cases
Employers must complete and provide Form IA 12.3 to employees at the time of separation from employment, regardless of the reason or duration of the separation. This requirement applies whenever an employee goes off the payroll, whether the separation is permanent, temporary, or indefinite. The form must be given to employees who are laid off (temporarily or permanently), discharged for cause, voluntarily quit, or have their work hours reduced to 30 or fewer hours per week.
Late or Corrected Situations
There is no "late" or "amended" version of Form IA 12.3 in the traditional sense, as this is not a form filed with the state—it is provided directly to the employee. However, if an employer fails to provide the form at the time of separation, they should provide it as soon as the oversight is discovered. If an employer provides a form with incorrect information (such as a wrong employer registration number or incorrect address for payroll records), the employer should promptly provide a corrected form to the employee. The failure to provide this form when required can result in penalties and may delay the employee's ability to file for unemployment benefits, which could lead to inquiries or enforcement actions from the Department of Labor.
Because the form serves as the employee's documentation when filing for benefits, providing it promptly and accurately is critical. The employee should keep the certificate and have it available when filing a claim for Unemployment Insurance benefits, either online at www.labor.ny.gov or by calling the Telephone Claim Center at 1-888-209-8124.
Key Rules or Details for 2017
Mandatory Requirements
New York State law establishes clear requirements for Form IA 12.3. First, the form must be provided for every type of employment separation—there are no exceptions based on the reason for leaving or whether the separation is expected to be short-term. Second, employers cannot deduct any costs associated with unemployment insurance contributions from an employee's wages, and providing this form is part of the employer's mandatory responsibility without any cost passed to the employee.
Required Information
The form must contain four specific pieces of information:
- The employer's name
- The New York State employer registration number
- The mailing address where payroll records are kept
- A statement instructing the employee to present the notice when filing a claim
If any of these elements are missing or incorrect, the form does not satisfy the legal requirement.
Recordkeeping Rules
Employers must maintain records of employment for at least four years, including documentation that Form IA 12.3 was provided to separated employees. While the form itself is given to the employee and not filed with the state, employers should retain copies or records showing compliance with this requirement in case of an audit or inquiry from the Department of Labor.
Substitute Forms
Employers who wish to use a substitute form rather than the official Form IA 12.3 must obtain written approval from the Department of Labor's Liability and Determination Section before using that substitute. The substitute form must contain all required information in a clear and accessible format. Using an unapproved substitute form does not satisfy the legal requirement and may result in penalties.
Step-by-Step (High Level)
Step 1: Obtain blank forms
Before you need them, request a supply of Form IA 12.3 from the New York State Department of Labor. You can order forms by calling the Employer Hotline toll-free at 1-888-899-8810, downloading and printing the form from www.labor.ny.gov, or writing to the department's Registration Section at the Unemployment Insurance Division, Harriman State Office Campus, Albany, NY 12226. Keep blank forms on hand so you can provide them immediately when an employee separates.
Step 2: Complete the employer information section
When an employee is separated from employment, fill in the top portion of the form with accurate employer information. Enter your business name exactly as registered with the state, your New York State employer registration number, and the complete mailing address where your payroll records are maintained. If you use optional fields such as payroll or clock number or location codes to help identify the employee in your records, complete those fields as well. Date the form with the date you are providing it to the employee.
Step 3: Provide the form to the separated employee
Give the completed form to the employee on their last day of work or as soon as possible after separation. Do not mail it to the Department of Labor—the form is for the employee's use. The employee should complete the lower section with their name and Social Security number. Explain to the employee that they should keep this certificate and have it with them if they file a claim for unemployment insurance benefits.
Step 4: Retain documentation
Keep a copy of the completed form or maintain a record showing that you provided Form IA 12.3 to the separated employee. Store this documentation with your employment records for at least four years in case of audit or inquiry.
Step 5: Respond to Department of Labor inquiries
If a former employee files for unemployment benefits, you may receive a Notice of Potential Charges (Form LO 400) from the Department of Labor asking you to verify wages and provide information about the separation. Respond promptly and accurately to these requests, as errors or delays can result in incorrect charges to your unemployment insurance account and affect your future UI contribution rates.
Common Mistakes and How to Avoid Them
Mistake 1: Failing to provide the form for all types of separations
Some employers mistakenly believe Form IA 12.3 is only required for layoffs or permanent terminations. In fact, the form must be provided whenever an employee goes off the payroll, including voluntary quits, discharges for cause, temporary layoffs, and situations where hours are reduced to 30 or fewer per week. To avoid this mistake, establish a standard termination procedure that includes completing and providing Form IA 12.3 for every employee separation, regardless of circumstances.
Mistake 2: Using outdated or unapproved forms
The New York State Department of Labor periodically updates Form IA 12.3, and employers who use old versions or create their own substitute forms without approval may not be in compliance. Always use the current version of the official form available from the Department of Labor's website, or obtain written approval before using a substitute form. Check the form revision date (shown on the bottom of the form, such as "IA 12.3 (11/23)") to ensure you are using the most recent version.
Mistake 3: Providing incomplete or inaccurate information
Common errors include leaving blank the employer registration number, providing an outdated business address, or using the Federal Employer Identification Number (FEIN) instead of the New York State employer registration number. While the form requests both numbers, make absolutely certain the New York State employer registration number is correct, as this is the key identifier for unemployment insurance purposes. Double-check all information before giving the form to the employee. Keep your employer registration documents readily accessible so you can reference the correct numbers when completing the form.
Mistake 4: Mailing the form to the Department of Labor instead of giving it to the employee
Form IA 12.3 is not filed with any government agency—it is provided directly to the separated employee for their use when filing for unemployment benefits. The employee presents the information from this form to the UI Claims Center when applying for benefits. Employers who mail the form to the Department of Labor instead of giving it to the employee have not satisfied the legal requirement. Ensure your HR staff and managers understand that the form goes to the employee, not to the state.
Mistake 5: Delaying providing the form
Some employers wait until they receive an inquiry from the Department of Labor before providing separation documentation. By that time, the employee may have already attempted to file for benefits without the necessary information, causing delays and frustration. Provide Form IA 12.3 to the employee on their last day of work or within one business day of separation. If you discover you failed to provide the form, remedy the oversight immediately by contacting the former employee and providing the completed form.
Mistake 6: Failing to keep records of compliance
Employers sometimes provide the form to employees but do not retain any documentation proving they did so. If the Department of Labor inquires about whether the form was provided or if a dispute arises, the employer has no proof of compliance. Make copies of completed forms or maintain a separation log documenting the date Form IA 12.3 was provided to each separated employee. Retain these records for at least four years along with other employment tax records.
What Happens After You File
Since Form IA 12.3 is not filed with the Department of Labor but is instead given to the employee, the immediate result is that the employee receives the documentation they need to apply for unemployment insurance benefits. The separated employee should keep the form and have it available when filing a claim for UI benefits, either online at www.labor.ny.gov or by calling the Telephone Claim Center toll-free at 1-888-209-8124. When filing, the employee will need to provide the employer information from the form, including the employer's name, New York State employer registration number, and Federal Employer Identification Number.
After the employee files for benefits, the Department of Labor will determine whether the individual is entitled to unemployment insurance based on their work history, wages earned, and the circumstances of separation. If the Department of Labor determines the former employee is potentially entitled to benefits, they will send you a Notice of Potential Charges (Form LO 400).
You must respond to the LO 400 within the timeframe specified on the notice—typically within 10 days. If you see wage discrepancies or have information about why the employee should not receive benefits, provide that information promptly.
If the employee receives unemployment benefits, the Department of Labor will send you periodic Notices of Experience Rating Charges (Form IA 96). You have appeal rights if you disagree with any determination.
FAQs
Do I need to provide Form IA 12.3 if an employee quits voluntarily?
Yes. The requirement to provide Form IA 12.3 applies to all employment separations, regardless of whether the employee was laid off, discharged, or voluntarily resigned.
What is the difference between the New York State employer registration number and the Federal Employer Identification Number?
The FEIN is issued by the IRS for federal tax purposes. The New York State employer registration number is used specifically for unemployment insurance purposes within New York.
Can I create my own version of Form IA 12.3?
You may create a substitute form only with written approval from the New York State Department of Labor.
What should I do if I forgot to give an employee Form IA 12.3?
Provide the form as soon as possible and document your efforts to correct the oversight.
Does providing Form IA 12.3 mean I agree the employee is eligible for unemployment benefits?
No. It is simply a legal requirement and does not determine eligibility.
How long should I keep records?
You should retain records for at least four years.
Do I need to provide the form if hours are reduced?
Yes, if hours are reduced to 30 or fewer per week.
