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Uploaded by dah viral? on Nov 22, 2022

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Nov 22, 2022
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payroll report template 02
The weekly submittal of this form is required by 29 CFR Part 3. * Full name, address, and social security number must appear on the first payroll on which the employee's name appears. The social security number is collected for payroll purposes.
WEEKLY PAYROLL REPORT ** Fringe benefit details MUST be reported on a supplementary page.

Copyright
WISCONSIN DEPARTMENT OF TRANSPORTATION *** Include private work.
DT 1929 11/2022 (Replaces EC 674) **** If Operating Engineer or Laborer, include equipment or skill level of employee.
Payroll # Contractor Name State Project ID Federal Project ID County Payroll Period Sheet #

Week Ending

____ Prime Contractor ____ Sub contractor Hired By:

© © All Rights Reserved


Enter information below on every individual that DAILY HOURS WORKED TOTAL (A) BASIC (B) BENEFITS HOURLY RATE (A) + (B) PROJECT WAGES

you employed on this project during the S= Straight Time O=Overtime WEEKLY HOURLY FUND CASH TOTAL FICA FED WH ST WH OTHER NET CHECK

payroll repo rt period* SU M TU W TH F SA HRS WORKED RATE PAYMENT PAYMENT HOURLY RATE GROSS WAGES (SPECIFY) PAID #

Name REFERENCED PROJECT


S 0 0 0 0
O 0 0 0
S.S. # OTHER PROJECTS ***
S

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Craft
Apprentice ___Yes ___ No TransGrad _ O
Name REFERENCED PROJECT
S 0 0 0 0
O 0 0 0
S.S. # OTHER PROJECTS ***
Craft S
Apprentice ___Yes ___ No TrnsGrad __ O
Name REFERENCED PROJECT
S 0 0 0 0
O 0 0 0
S.S. # OTHER PROJECTS ***
Trade S
Apprentice ___Yes ___ No TrnsGrad __ O
Name REFERENCED PROJECT
S 0 0 0 0
O 0 0 0
S.S. # OTHER PROJECTS ***
Trade S

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Apprentice ___Yes ___ No TrnsGrad __ O
Name REFERENCED PROJECT
S 0 0 0 0
O 0 0 0
S.S. # OTHER PROJECTS ***
Craft S
Apprentice ___Yes ___ No TrnsGrad __ O
Name REFERENCED PROJECT
S 0 0 0 0
O 0 0 0


S.S. # OTHER PROJECTS ***
Trade S
Apprentice ___Yes ___ No TrnsGrad __ O

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