FINAL PAYCHECK WORKSHEET
FINAL PAYCHECK WORKSHEET
Name: _________________________________________ Date: ___________________
Current Address: ________________________________________________________
Social Security #: __________________________ Prepared by: __________________
Employee paid previously through (date): ___________________________________
Unpaid hours begin on (date): _____________________________________________
Final date of employment: __________________ Time: __________________am/pm
ٱ The separation is a voluntary termination – (employee initiated: resignation, retirement) – the final paycheck must be issued within 72 hours of the final date of employment or by ____________________.
ٱ The separation is an involuntary termination – (employer initiated: discharge or layoff with no date of rehire) – all wages and accrued vacation earned but unpaid are due and payable on the last day of work.
Time:
Dates: | | | | | | | | | |Hours Worked |Mon |Tue |Wed |Thur |Fri |Sat |Sun |Total | |Regular Hours | | | | | | | | | |Overtime Hours | | | | | | | | | |Total Hours Worked | | | | | | | | | |
Dates: | | | | | | | | | |Hours Worked |Mon |Tue |Wed |Thur |Fri |Sat |Sun |Total | |Regular Hours | | | | | | | | | |Overtime Hours | | | | | | | | | |Total Hours Worked | | | | | | | | | |
Dates: | | | | | | | | | |Hours Worked |Mon |Tue |Wed |Thur |Fri |Sat |Sun |Total | |Regular Hours | | | | | | | | | |Overtime Hours | | | | | | | | | |Total Hours Worked | | | | | | | | | |
Totals: ________________Regular Time
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