What New York Form IA 12.3 Is For
New York Form IA 12.3, officially titled "Record of Employment," is a notice document that New York State employers must provide to workers when they separate from their job. This form serves as proof that the employee worked for an unemployment insurance-covered employer and provides essential information the worker needs to file for unemployment insurance (UI) benefits.
The form itself is not an application for benefits or a guarantee that the employee will receive unemployment compensation. Instead, it acts as a bridge between the employer and the state's unemployment insurance system, ensuring that separated workers have the employer information necessary to file their claims quickly and accurately. The form contains four key pieces of information: the employer's name, the New York State employer registration number, the mailing address where payroll records are kept, and instructions telling the employee to present this information when filing for unemployment insurance benefits.
Under New York State law, this notification requirement has existed for many years, but it was expanded in recent years to cover more employment situations. The form helps streamline the unemployment claims process by ensuring that workers have accurate employer identification details, which the Department of Labor uses to determine benefit eligibility and charge the appropriate employer accounts.
When You’d Use New York Form IA 12.3
Separation Scenarios
Employers must provide Form IA 12.3 to employees at the time of separation—meaning whenever an employee goes off the payroll, regardless of the reason. This includes:
- Permanent layoffs
- Temporary layoffs
- Terminations
- Voluntary quits
- Reduced hours
The law does not distinguish between voluntary and involuntary separations.
Reduced Hours (Partial Unemployment)
The 2020 regulations expanded the requirement to include workers whose hours are reduced below the partial unemployment threshold.
Partial unemployment occurs when:
- An employee works less than 30 hours per week
- OR earns less than the maximum weekly benefit rate
If you reduce an employee’s schedule below 30 hours—even if they remain employed—you must provide the form.
Late or Missed Distribution
There is no formal “late filing” or “amended filing” process. However:
- If you failed to provide the form, give it as soon as possible
- Delays may slow the employee’s claim process
- The Department of Labor may contact you for missing information
Key Rules or Details for 2020
Requirement Applies to All Separations
You must provide the form regardless of:
- Termination reason
- Voluntary resignation
- Layoff status
- Hour reductions
Limited Exceptions
You do NOT need to provide the form in these cases:
- Employees under an approved Shared Work Plan
- Educational staff with reasonable assurance of continued employment
Use of Official Form
- Must use the official Department of Labor form or an approved equivalent
- Custom versions require written approval
Timing Requirements
- Provide at time of separation or reduction in hours
- For layoffs: last day or shortly after
- For reduced hours: when the change is communicated
Required Information
The form must include:
- Business name
- NY employer registration number (7-digit)
- Payroll records address
- Instruction statement for the employee
Coverage Scope
Applies to nearly all employee types:
- Household employees
- Seasonal workers
- Part-time workers
- Fluctuating schedule industries
Step-by-Step (High Level)
Step 1: Obtain the Form
- Download from dol.ny.gov
- Call Employer Hotline (1-888-899-8810)
- Order online
Step 2: Complete Employer Information
Fill in:
- Date issued
- Business name (as registered)
- NY employer registration number
- Federal Employer Identification Number (FEIN)
- Payroll records address
Step 3: Optional Details
You may include:
- Employee payroll/clock number
- Work location or internal code
Step 4: Employee Section
- Completed by the employee
- Includes name and Social Security number
Step 5: Deliver the Form
Provide via:
- In person
- Electronic delivery
Step 6: Retain Records
- Keep a copy for at least 4 years
- Do not submit to the Department of Labor
Common Mistakes and How to Avoid Them
Not Providing the Form for All Separations
Mistake:
Only issuing the form for layoffs or terminations
Solution:
Make it part of every separation checklist
Missing Reduced Hours Requirement
Mistake:
Ignoring partial unemployment scenarios
Solution:
Train managers to flag reductions below 30 hours
Using Outdated Forms
Mistake:
Using old or copied versions
Solution:
Always download the latest version from dol.ny.gov
Incomplete or Incorrect Information
Mistake:
Leaving fields blank or entering wrong registration numbers
Solution:
Double-check all required fields before issuing
Not Keeping Copies
Mistake:
Failing to retain documentation
Solution:
Store copies in employee records for compliance
What Happens After You File
No Government Filing Required
You do not submit Form IA 12.3. Instead:
- Give it directly to the employee
- The employee uses it when filing for UI benefits
Employee Claim Process
Employees provide:
- Employer name
- Address
- Registration number
- Employment history (last 18 months)
Department Review
The Department of Labor:
- Uses your registration number
- Reviews NYS-45 wage reports
- Determines eligibility
Employer Notifications
You may receive:
- Notice of Potential Charges (LO 400)
- Notice of Experience Rating Charges (IA 96)
Employer Response
- Respond within ~10 days if applicable
- Provide corrections or dispute claims if needed
Timeline
- Typical processing: 3–6 weeks
- Employer role: respond to notices and provide accurate info
FAQs
Do I need to provide Form IA 12.3 if an employee voluntarily quits?
Yes. The law requires you to provide Form IA 12.3 to all employees who separate from employment, regardless of whether the separation was voluntary or involuntary. This includes resignations, retirements, and any other type of departure.
What if an employee’s hours fluctuate weekly?
You must provide the form when hours drop below 30 per week or earnings fall below the maximum benefit rate. If hours later increase, no additional form is required unless another qualifying reduction occurs.
Can I create my own version of Form IA 12.3?
No, unless approved in writing by the Department of Labor. The form must include all required elements. Most employers use the official version to avoid compliance issues.
Do independent contractors receive this form?
No. Only employees covered by unemployment insurance qualify. Misclassification risks still apply if a worker is incorrectly labeled as a contractor.
What if I forgot to provide the form?
Provide it immediately once discovered. While there is no direct penalty, delays can affect claims and trigger Department inquiries.
Do seasonal employees need this form?
Yes, if they meet separation criteria. Exception applies if “reasonable assurance” of continued employment exists for the next season.
Who is responsible if I use a payroll service?
You are responsible. Payroll providers may assist, but compliance ultimately rests with the employer.