Payroll And Earnings Statement
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1Payroll and Earnings Statement
Employer
Employee
Employee Number
Name
Salary For The Period:
Beginning
Ending
Earnings
Rate
Total
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Per
Total
Hours
Hour
Regular
Hours
Worked
Overtime
Hours
Non Cash Compensation
Other Amounts Due – Commission, Special Allowances Etc.
Total Wages Or Salary
Gratuity / Tips Received directly By The Employee
Total Earnings
Tax Deductions
FICA
Federal Income Tax Withheld
State Income Tax Withheld
Less total Tax deductions
Net earnings after deductions
Other Deductions
Non Cash Compensation.
Gratuity / Tips Received directly By The Employee
Total of all other deductions
Paid in Cash
or Check
or Account Transfer
or other
– Specify ___________ Net Amount Due :
I certify the correctness of the above calculations and acknowledge the receipt of the net amount due to me.
Employee’s Signature _____________________________________ Date _________________________
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Parent category: Legal