DT1929 Weekly Payroll Report
|WEEKLY PAYROLL REPORT |The weekly submittal of this form is required by 29 CFR Part 3. * Full name, address, and social security number must appear on the |
|Wisconsin Department of Transportation |first payroll on which the employee’s name appears. The social security number is collected for payroll purposes. |
|DT1929 9/2006 (Replaces EC674) |** Fringe benefit details MUST be reported on a supplementary page. *** Include private work. |
| |**** If Operating Engineer or Laborer, include class of equipment or skill level of laborer. |
|Payroll # |Employer Name |State Project ID |Federal Project ID |County |Payroll Period Week |Sheet # |
| | | | | |Ending | |
| |Prime Contractor Subcontractor Hired By: | | | | | |
Enter information below on every individual that you employed on this project during the payroll report period.* |DAILY HOURS WORKED
S = Straight Time O = Overtime |TOTAL WEEKLY HOURS
WORKED |(A)
BASIC
HOURLY
RATE |(B) BENEFITS **
HOURLY RATE |(A) + (B)
TOTAL HOURLY
RATE |PROJECT
WAGES |FICA |FED WH |ST WH |OTHER
(Specify) |NET
PAID |CHECK
# | | | | | |FUND
PAYMENT |CASH
PAYMENT | |GROSS
WAGES | | | | | | | | | |SU |M |TU |W |TH |F |SA | | | | | | | | | | | | | |Name
Address
City, State, ZIP Code
S.S. #
Trade/Craft ****
Apprentice Yes No |REFERENCED PROJECT | | |
| | | | | | | | | | | |S | | | | | | | | |$ |$ |$ |$ | | | | | | | | | |O | | | | | | | | |$ |$ |$ |$ |$ | | | | | | | | |OTHER PROJECTS *** | | |$ |$ |$ |$ |$ |$ | | | |S | | | | | | | | | | | | | | | |O | | | | | | | | | | | | | | |Name
Address
City, State, ZIP Code
S.S. #
Trade/Craft ****
Apprentice Yes No |REFERENCED PROJECT | | | | | | | | | | | | | | |S | | | | | | | | |$ |$ |$ |$ | | | | | | | | | |O | | | | | | | | |$ |$ |$ |$ |$ | | | | | | | | |OTHER PROJECTS *** | | |$ |$ |$ |$ |$ |$ | | | |S | | | | | | | | | | | | | | | |O | | | | | | | | | | | | | | |Name
Address
City, State, ZIP Code
S.S. #
Trade/Craft ****
Apprentice Yes No |REFERENCED PROJECT | | | | | | | | | | | | | | |S | | | | | | | | |$ |$ |$ |$ | | | | | | | | | |O | | | | | | | | |$ |$ |$ |$ |$ | | | | | | | | |OTHER PROJECTS *** | | |$ |$ |$ |$ |$ |$ | | | |S | | | | | | | | | | | | | | | |O | | | | | | | | | | | | | | |Name
Address
City, State, ZIP Code
S.S. #
Trade/Craft ****
Apprentice Yes No |REFERENCED PROJECT | | | | | | | | | | | | | | |S | | | | | | | | |$ |$ |$ |$ | | | | | | | | | |O | | | | | | | | |$ |$ |$ |$ |$ | | | | | | | | |OTHER PROJECTS *** | | |$ |$ |$ |$ |$ |$ | | | |S | | | | | | | | | | | | | | | |O | | | | | | | | | | | | | | |Name
Address
City, State, ZIP Code
S.S. #
Trade/Craft ****
Apprentice Yes No |REFERENCED PROJECT | | | | | | | | | | | | | | |S | | | | | | | | |$ |$ |$ |$ | | | | | | | | | |O | | | | | | | | |$ |$ |$ |$ |$ | | | | | | | | |OTHER PROJECTS *** | | |$ |$ |$ |$ |$ |$ | | | |S | | | | | | | | | | | | | | | |O | | | | | | | | | | | | | | |Name
Address
City, State, ZIP Code
S.S. #
Trade/Craft ****
Apprentice Yes No |REFERENCED PROJECT | | | | | | | | | | | | | | |S | | | | | | | | |$ |$ |$ |$ | | | | | | | | | |O | | | | | | | | |$ |$ |$ |$ |$ | | | | | | | | |OTHER PROJECTS *** | | |$ |$ |$ |$ |$ |$ | | | |S | | | | | | | | | | | | | | | |O | | | | | | | | | | | | | | |
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