Modern Paystub

Other benefits and information

Earnings

Deductions Statutory

CO.
FILE
DEPT.
CLOCK
NUMBER

MCB
02470383 0
Taxable Marital Status:
Exemptions/Allowances:
Earnings Statement
Period start:
Period ending:
Pay date:
Emp #:
Earningsratehoursthis periodyear to date
Regular
Overtime
Holiday
Vacation*
Bonus*
Float*
Gross Pay
$
DeductionsStatutory
Federal Income Tax
Social Security Tax
Medicare
State Income Tax
%   SUI/SDI Tax
Net Pay

* Excluded from federal taxable wages

Other Benefits and
Informationthis periodtotal to date
Group Term Life0.000.00
Loan Amt Paid0.00
Vac Hrs Left0.00
Sick Hrs Left0.00
Title
 
Important
Notes
60-162/433
Payroll check number:
Pay date
Social Security No.

SAMPLE
NON-NEGOTIABLE
VOID VOID VOID

VOID AFTER 180 DAYS

AUTHORIZED SIGNATURE