WEEKLY PAYROLL CERTIFICATION
PAYROLL CERTIFICATION FOR COVERED SERVICE WORKER CONTRACTS
WEEK-ENDING DATE:
~FOR FOOD SERVICE CONTRACTS ONLY~
WEEKLY PAYROLL
MALE/ WORK DAY AND DATES-TIME BASE HOURLYTYPE OF FRINGE GROSS PAY
TOTAL DEDUCTIONS
GROSS PAY FOR CHECK # ANDFEMALECLASSIFICATIONSMTWTHFS RATE BENEFITS FOR ALL WORKFEDERALSTATETHIS SERVICE NET PAYEMPLOYEE NAME AND ADDRESSAND Per Hour PERFORMEDCONTRACT JOBRACE** TOTAL FRINGE 1 through 6 THIS WEEKBENEFIT PLAN (see back)FICAWITH-WITH-OTHERHOURS WORKED EACH DAY O-TIME CASHHOLDINGHOLDING*** TIP CREDIT1. $$$2. $Base Rate Per Hour3. $Gross Pay4. $$$5. $
Cash Fringe Per Hour
6. $Tip Credit1. $$$2. $Base Rate Per Hour3. $Gross Pay4. $$$5. $
Cash Fringe Per Hour
6. $Tip Credit1. $$$2. $Base Rate Per Hour3. $Gross Pay4. $$$5. $
Cash Fringe Per Hour
6. $Tip Credit1. $$$2. $Base Rate Per Hour3. $Gross Pay4. $$$5. $
Cash Fringe Per Hour
6. $Tip Credit1. $$$2. $Base Rate Per Hour3. $Gross Pay$4. $$Cash Fringe Per Hour5. $Tip Credit1. $$$2. $Base Rate Per Hour3. $Gross Pay4. $$$5. $
Cash Fringe Per Hour
6. $Tip Credit*IF Required4/21/2005
NOTICE: THIS PAGE MUST BE ACCOMPANIED BY A COVER PAGE
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Department of Labor: foodservicepayroll
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Info and Rating
| Category: | Uncategorized. |
| Rating: | |
| Upload Date: | 01/26/2008 |
| Copyright: | Attribution Non-commercial |
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