Form Re-48 - Contractor'S Payroll Record
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1
2PUBLIC BUILDING COMMISSION OF CHICAGO
EXHIBIT N
CONTRACTOR’S PAYROLL RECORD FORM RE-48 (Rev. PW 1982)
(1 of 2)
Sheet _____ of _____
PAYROLL
Name of __ Contractor & No. __ or __ Subcontractor & No. __
Payroll No.
Project No.
Location
Tax Week Ending
Address
Project Name
Contract No
Name, Address and
Work
OT
Hours and Days Worked
Deductions
Net
Ethnic
Rate
Total
Social Security #
Classi-
or
Total
Federal
State
Total
Wages
Group
of Pay
Earned
of Employee
fication
ST
S
M
T
W
Th
F
S
Hours
WH Tax
FICA
WH Tax
Deduct.
Paid
S
O
S
O
S
O
S
O
S
O
S
O
S
O
S
Total No. Hours (Straight & Overtime) this Page
Reviewed By:
__________________________
No Work
___
Suspended ___
Completed
___
120
MARCH 2011
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