Nevada Notice to employees regarding tips

NOTICE TO	 	EMPLOYEES	 	
 
Pursuant to: 	NRS 616B.227 Election by employee to report his tips; effect; regulation.	 	
 
 
1. 	For the purpose of workers'	 compensation, an employee may elect to report the amount he 	
receives as tips for the purpose of the calculation of compensation by submitting to his employer 
an Employee’s Declaration of Election of Report Tips (form D	-23).  The employee must 	make his	 	
election separately for	 each pay period before the en	d of the next pay period.   The	 declaration 	
may not be	 amended.	 	
 
2. 	Upon receipt of such notice the employer	 shall:	 	
(a)	 	Make a copy of each report which the employee has filed with the employer to report the 
am	ount of his tips to the United States Internal Revenue Service or 	Employee's 	
Declaration of Election to Report	 Tips;	 	
(b)	 	Submit  the  copy  to  its  workers’  compensation  insurer  upon  request,  or  if  the  employer  is 
self	-insured  or  an  association  of  self	-insured  pub	lic  or  private  employers,  retain  the  copy 	
for his records;	 and	 	
(c)	 	If he is not self	-insured, pay the insurer the premiums for the reported tips at the same 	
rate as he pays on regular	 wages.	 	
 
3. 	An employee who elects to report his tips is not eligible to receive increased compensation based 
on 	those tips until 3 months after	 his employer  receives the 	Employee's 	Declaration of Election to 	
Report Tips. For the purpose of workers' compensation, ti	ps may be reported pursuant to	 26	 	
U.S.C. §6053(a) or on form D	-23. The form for reporting tips D	-23 can be obtained from your 	
personnel office.	 	
 
If the forms are not available, contact your employer or the Internal Revenue Service.	 	
 
 
 
 	
D-22 	(rev. 7/99)