EMPLOYEE EARNINGS RECORD - Free Forms Online

[Pages:1]EMPLOYEE EARNINGS RECORD

NAME (LAST) ADDRESS

FIRST

MIDDLE

EMP ID# CITY

# EXEMPTIONS STATE

SOCIAL SECURITY # ZIP

QUARTER

RATE

REGULAR

O.T.

REGULAR

EARNINGS O.T.

HOURS WORKED

PAY PERIOD REGULAR

O.T.

REGULAR

EARNINGS O.T.

FICA

TOTAL

FICA

TAXES W.H.

TAXES W.H.

DEDUCTIONS

DATE EMPLOYED

DEDUCTIONS

NET PAY

QUARTER

TOTAL

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