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Company details

Earnings statement
Employee information Social Security number Reporting period Pay date Employee ID

Name
Address

Payment Rate Hours Gross Year to Date Bonus Deductions Current Year to Date
type earnings Deductions
Regular Federal tax
Overtime State tax
Social Security
tax
Other

PTO balance

Available hours Used hours Left hours Total used PTO

Year to Date Gross Year to Date Year to Date Net Gross pay Total current Net pay
deductions deductions

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