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YOUR LOGO

* Business
Name* * Employee Name *
* DBA * * Employee ID Number *
* Business Address * * Employee Address *
* Business City / State / Zip * * Employee City / State / Zip *

Description Rate Hours Earing’s Year to Date Description year to date


Regular eating’s 12.00 14.00 26.00 Federal Tax 0.00
Overtime Teamings 41.00 14.00 55.00 State Tax 0.00
Back Pay 0.00 0.00 0.00 Medicare Tax 0.00
Holiday Teamings 0.00 0.00 0.00 Medical Insurance 0.00
Vacation Teamings 0.00 0.00 0.00 401(K) 0.00
Uniforms 0.00
Union Dues 0.00

Checking ACH 0.00

Teamings Taxs Deductions Net Pay Deposit Number Amount of Check


Pay Period 0/00/00-0/00/00

Year to Date

* Type the company name * Confidential

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