EMPLOYEE PAY STUB

EMPLOYER NAME EMPLOYEE NAME

EMPLOYER ADDRESS EMPLOYEE ADDRESS

EMPLOYER TELEPHONE EMPLOYEE #

CHECK # SSN (LAST FOUR DIGITS)

PAY PERIOD PAY DATE

-

GROSS EARNINGS RATE HOURS CURRENT TOTAL YEAR TO DATE

REGULAR
OVERTIME
OTHER

DEDUCTIONS CURRENT TOTAL YEAR TO DATE

FICA – MEDICARE
FICA – SOCIAL SECURITY
FEDERAL TAX
STATE TAX
OTHER

CURRENT GROSS YEAR TO DATE GROSS

CURRENT DEDUCTIONS YEAR TO DATE DEDUCTIONS

CURRENT NET PAY YEAR TO DATE NET PAY