New York State Department of Labor

https://labor.ny.gov/formsdocs/wp/ellsformsandpublications.shtm#Employment_Agency

$250-$700 depending on multiple factors.

PEO Registration Application LS665

email

$250-$700 depending on multiple factors.

Biennially

Form LS665: PEO Registration Application

Mail to: 
New York State Department of Labor Division of Labor Standards 
Permit and Certificate Unit  
State Office Campus 
Building 12, Room 185B 
Albany, NY 12240 

Mail

$0

• List the current address of each additional office the individual PEO or parent organization maintains in New York
• Other than those included in the above list, list the addresses of each office you maintained in New York during the past five years. Include any other names used and names of any predecessors and successors, if known.
• If the applicant PEO is privately or closely held, a list of all persons or entities that own a 5% or greater interest in the individual PEOor the parent organization of the PEO group at the time of this application.
• A list all persons not listed above that have owned a 5% or greater interest in the individual PEO or the parent organization of the PEO group in the five years preceding the date of this application.
• If the applicant PEO or its parent company is a publicly traded company, a list of all persons or entities that own 50% or greater interest in the PEO or the parent company of the PEO.
• A copy of the corporate filing receipt and/or authorization to do business in New York State from the New York State Secretary of State
• A blank client contract incorporating the requirements of Article 31 of the New York Labor Law and a sample written notice to worksite employees
• A list of all New York clients including the name, address, FEIN, type of business, name of the New York State Workers’ Compensation and Disability Insurance policyholders, and number of employees for each client.
• A reviewed or audited financial statement of the PEO’s most recent fiscal year. The statement must have been prepared within 180 days prior to the submission by an independent certified public accountant (CPA) using generally accepted accounting principles (GAAP) and must show a minimum net worth of $75,000. The statement must be accompanied by a cover letter, signed by the independent CPA, certifying that (1) the statement fairly represents the financial position of the firm in accordance with GAAP and (2) there is reasonable assurance that the firm has timely paid all applicable federal and state payroll taxes on all New York employees (for example: office, worksite, etc.) for that fiscal year and explaining the basis for these certifications.
• Proof of New York Workers’ Compensation and Disability Insurance

Form LS665: PEO Registration Application (Renewal)

Mail

$0

Annually within 180 days after the end of the PEO’s fiscal year.

• List the current address of each additional office the individual PEO or parent organization maintains in New York
• Other than those included in the above list, list the addresses of each office you maintained in New York during the past five years. Include any other names used and names of any predecessors and successors, if known.
• If the applicant PEO is privately or closely held, a list of all persons or entities that own a 5% or greater interest in the individual PEOor the parent organization of the PEO group at the time of this application.
• A list all persons not listed above that have owned a 5% or greater interest in the individual PEO or the parent organization of the PEO group in the five years preceding the date of this application.
• If the applicant PEO or its parent company is a publicly traded company, a list of all persons or entities that own 50% or greater interest in the PEO or the parent company of the PEO.
• A blank client contract incorporating the requirements of Article 31 of the New York Labor Law and a sample written notice to worksite employees
• A list of all New York clients including the name, address, FEIN, type of business, name of the New York State Workers’ Compensation and Disability Insurance policyholders, and number of employees for each client.
• A reviewed or audited financial statement of the PEO’s most recent fiscal year. The statement must have been prepared within 180 days prior to the submission by an independent certified public accountant (CPA) using generally accepted accounting principles (GAAP) and must show a minimum net worth of $75,000. The statement must be accompanied by a cover letter, signed by the independent CPA, certifying that (1) the statement fairly represents the financial position of the firm in accordance with GAAP and (2) there is reasonable assurance that the firm has timely paid all applicable federal and state payroll taxes on all New York employees (for example: office, worksite, etc.) for that fiscal year and explaining the basis for these certifications.
• Proof of New York Workers’ Compensation and Disability Insurance

Mail to: 
New York State Department of Labor Division of Labor Standards 
Permit and Certificate Unit  
State Office Campus 
Building 12, Room 185B 
Albany, NY 12240 

Mail

$0

Within 60 days of the end of each calendar quarter.

PEOs must submit a statement, signed by an independent CPA, certifying that there is reasonable assurance that the firm has timely paid all applicable federal and state payroll taxes on all New York employees for that quarter and explaining the basis for this certification.

Mail to: 
New York State Department of Labor Division of Labor Standards 
Permit and Certificate Unit  
State Office Campus 
Building 12, Room 185B 
Albany, NY 12240 

Mail

$0

Within 60 days of the end of each calendar quarter.

PEOs must submit a client list showing all changes since the last list submitted. Include the name and address, FEIN, type of business, and name of New York State Workers’ Compensation and Disability Insurance policyholders for each new client. The list should be signed by an officer, partner, owner or member, certifying the list is complete, current and accurate.

Form LS671: PEO Exemption Application

Mail the completed request with all attachments to:
New York State Department of Labor
Division of Labor Standards
Permit and Certificate Unit
Harriman State Office Campus
Building 12, Room 185B
Albany, NY 12240

Mail

$0

Authorized Signers

• If a corporation, the application must be signed by the chief executive officer of the corporation.
• If a partnership, proprietorship or LLC the application must be signed by a partner, owner or member
  authorized to bind the entity

• A list of states in which the PEO is licensed or registered as a PEO, its license or registration number, and the State Agency that issued it
• A copy of the corporate filing receipt and/or authorization to do business in New York State from the New York State Secretary of State
• A blank copy of the contract used with clients
• A list of all New York clients including the name, address, FEIN, type of business, name of the New York State Workers’ Compensation and Disability Insurance policyholders, and number of employees for each client.
• Form CE 200. Information and a copy of this form are available from any District Office of the New York State Workers’ Compensation Board
• A copy of your PEO Registration from another state that has the same, or greater, requirements as NYS

Form LS671: PEO Exemption Application (Renewal)

$0

Annually within 180 days after the end of the PEO’s fiscal year. 

• States in which the PEO is licensed or registered as a PEO, its license or registration number, and the State Agency that issued it
• A blank copy of the contract used with clients
• A list of all New York clients including the name, address, FEIN, type of business, name of the New York State Workers’ Compensation and Disability Insurance policyholders, and number of employees for each client.
• Form CE 200. Information and a copy of this form are available from any District Office of the New York State Workers’ Compensation Board
• A copy of your PEO Registration from another state that has the same, or greater, requirements as NYS