[NOTE: The following sample questionnaire is used with the New York Security Agreements Library. If you ordered the library for some other jurisdiction, some of the questions and terms would be different.]


Identify Employer -



__male __female __corporation __partnership __LLC

Name of business (if different from Employer):

Identify Employee -



__male __female __corporation __partnership __LLC

Attorney for Employee:

__witnessing and attestation signatures

Date of Agreement: __ "as of" said date


Employment is:
__full time
__part time
__casual-when needed

To commence:
__on date of Agreement
__on other date:
__on occurrence of some event:

To terminate: [also see TERMINATION PROVISIONS below]
__on specific date:
__"at the will" of Employer - Employer may terminate any time
__Employee may resign at any time
__Agreement to be silent on subject

Re extension of the Agreement:
__automatic extension
period of extension:
any changes in compensation:
prior notice to cancel the extension:

__repeated extensions (not just one)

__merely recite that parties may negotiate an extension

__Agreement to be silent on subject


__an executive position
__authority to hire and fire staff
__attach a job description as an exhibit
__Employer may update and modify duties in a reasonable manner
__Employee to comply with written rules and policies
__Employer has employee manual
__Employee promises to work to the best of ability
__specify location of the work:
__Employee is to report to specific manager:

__review of Employee's performance at least annually
__Employer is to set annual objectives for Employee
__Employer may conduct review without Employee being present
__ report any unsatisfactory performance in writing
__the parties anticipate that compensation may be increased annually

__Employee may be temporarily assigned elsewhere

__include a general recitation that parties intent to act in "good faith" with respect to each other

__Employee to warrant that there are no conflicting obligations

__discuss the hours of work

__specify the normal hours of work:
__parties will later agree on the hours to be worked
__but Employer will have final say on what the hours will be
__Employee is to be "on call" (e.g., a doctor)

__specify a guaranteed minimum number of hours of work:
__recite that there is no guaranteed minimum
__don't discuss minimum hours

__Employee agrees to work additional hours as Employer may require
__Employee to be entitled to compensatory time off
__Employee to endeavor to be available when required
__Employee is exempt from federal overtime laws
__Employer is amenable to flexible hours for the Employee
__Agreement to discuss maximum number of continuous work days:

__discuss breaks -
__reasonable meal and other breaks
__specific breaks:

__discuss vacation time (specify amount of vacation during initial period of employment and subsequent years, whether vacation may be carried over to subsequent years, any compensation for unused vacation time, etc.):

__discuss work on holidays (specify whether or not Employee is to work on holidays, any additional compensation or alternative time off, whether Employee may be "on call" on holidays, etc.):

__discuss sick leave (whether specific numbers of sick days are to be provided, with or without pay or partial pay, etc.):

__discuss family leave (whether specific numbers of family leave days are to be provided, with or without pay or partial pay, who is to constitute family, whether Family Leave Act is applicable, etc.):

__discuss military leave:

__discuss unpaid leave:

__discuss an annual close down by Employer:

__discuss jury duty:


__use of computers
__use of chemicals
__job involves lifting
__discuss drug testing:

__discuss counseling for personal problems:

__require medical examinations:


__Employee agrees not to disclose confidential information
__including privacy of customers/clients

__Employee is "work for hire" (Employer owns all rights)

__Employee will refrain from making negative statements re Employer

__Employee acknowledges a "fiduciary duty" to Employer

__Employee prohibited from activities that interfere with work
__other than lecturing or other short duration acts

__Employee may make investments if they do not conflict

__Employee not to compete after termination of employment -
For how long:

__Employee not to solicit customer/clients after termination

__Employee not to solicit Employer's employees after termination

__Employee is a non-citizen


__an annual salary (describe initial salary, any agreed to dollar amount or percentage increases on anniversaries or other times, etc.):

__Employee have defer a portion of the salary:

__hourly wages (describe initial wages, any agreed to dollar amount or percentage increases on anniversaries or other times, etc.):

Compensation is to be paid:
__every other week

__discuss overtime pay (time and a half or other agreed to amounts, etc.):

__Employee is to receive a signing bonus: $

__compensation is to increase upon attaining a qualification (e.g. receipt of a license):

__discuss bonuses -
__bonuses are solely at discretion of Employer
__parties anticipate bonuses:

__Employee is to receive commissions based on revenues/sales:

__Employer has an employee incentive plan

__Employee is to have stock options:

__Employee is to be reimbursed for expenses:

__including travel expenses

__Employee's compensation is to be reviewed annually


__Employer has a comprehensive employee benefit package:

__but the benefits may be changed for all employees

__Employer provides medical coverage:

__Employer provides life or disability insurance:

__Employer provides dental coverage:

__Employer provides glasses or vision benefits:

__Employer provides liability insurance:

__Employer is to indemnify Employee from liability

__Employer pays for a bond for Employee:

__Employer provides housing for Employee:

__Employer pays moving expenses:

__Employer pays house sale expenses:

__Employer provides meals:

__Employer pays for club or gym:

__Employer pays for mobile phone:

__Employer provides or pays for automobile:

__Employer provides or pays for parking:

__discuss office space, secretarial assistance:

__Employer pays for professional dues and fees:

__Employer pays for continuing education:

__discuss child care:

__Employer has an employee retirement plan:


__there's a probation period, to evaluate whether Employee is to be retained:

__Employee may voluntarily resign - specify notice period:

__Employer may voluntarily terminate Employee's employment - notice period:

__Employer may terminate Employee's employment for cause:

__Employee may terminate Employee's employment for cause:

__Employee is to be entitled to severance compensation unless terminated for cause (specify the amount and how it may increase depending on the duration of employment, whether the payments are to be paid over time, the continuation of fringe benefits for a period, etc.):


__Employee has three days for an attorney to review the Agreement

__disputes are to be resolved by arbitration - where:

__if there is a dispute, prevailing party pays for attorneys' fees

__Employer is entitled to injunctive relief

__specify venue or location for disputes:

The DL Employment Agreements Library for New York is a new program. We would appreciate any suggestions or comments you may have to make the program better.

The program uses a new feature of Version 9 of DL. Many questions display proposed language which you can edit. We suggest that you do a couple of test runs to familiarize yourself with the proposed language.

If you find that you typically want to revise the proposed language, you can create a "template" that preserves the revised language you desire. You run the program but so not enter specifics such as the names of the parties. But otherwise pick the most frequently used answers to the questions, and revise the proposed language for the questions. Save your answers and record the number of the Index File that contains your answers. Later, when you want to create a real Employment Agreement for a client, elect to use the answers stored in that Index File. [DL's Help system has more details about creating templates.]